Improving glycemic control in diabetics showing fasting chylomicronemia usually reduces the need for pharmacologic intervention.Statins remain the first line for treatment of blood cholesterol. AHA guidelines from 2013 did not find evidence for routine use of additional medications.Additionally, in 2016, the FDA filed "Withdrawal of Approval of Indications Related to the Coadministration With Statins in Applications for Niacin Extended-Release Tablets and Fenofibric Acid Delayed Release Capsules" noting "the Agency has concluded that the totality of the scientific evidence no longer supports the conclusion that a drug-induced reduction in triglyceride levels and/or increase in HDL cholesterol levels in statin-treated patients results in a reduction in the risk of cardiovascular events. Consistent with this conclusion, FDA has determined that the benefits of niacin ER tablets and fenofibric acid DR capsules for coadministration with statins no longer outweigh the risks, and the approvals for this indication should be withdrawn." COVID-19
In August 2021, researchers in the UK and Italy reported laboratory findings that fenofibrate can significantly reduce SARS-CoV-2 infection in vitro.
While its use is widespread, the NYHA score is not very reproducible and does not reliably predict the walking distance or exercise tolerance on formal testing.In its 2001 guidelines, the American College of Cardiology/American Heart Association working group introduced four stages of heart failure:
Stage A: People at high risk for developing HF in the future, but no functional or structural heart disorder
Stage B: A structural heart disorder, but no symptoms at any stage
Stage C: Previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment
Stage D: Advanced disease requiring hospital-based support, a heart transplant, or palliative careThe ACC staging system is useful since stage A encompasses "pre-heart failure" – a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC stage A does not have a corresponding NYHA class. ACC stage B would correspond to NYHA class I. ACC stage C corresponds to NYHA class II and III, while ACC stage D overlaps with NYHA class IV. The degree of coexisting illness: i.e. heart failure/systemic hypertension, heart failure/pulmonary hypertension, heart failure/diabetes, heart failure/kidney failure, etc. Whether the problem is primarily increased venous back pressure (preload), or failure to supply adequate arterial perfusion (afterload)
Whether the abnormality is due to low cardiac output with high systemic vascular resistance or high cardiac output with low vascular resistance (low-output heart failure vs. high-output heart failure)

Histopathology
Histopathology can diagnose heart failure in autopsies. The presence of siderophages indicates chronic left-sided heart failure, but is not specific for it.