Los Angeles, CA
Joined December 2012
- Tweets12.1K
- Following178
- Followers12.7K
- Likes27.3K
Gregg Fonarow MD retweeted
What actually drives quality of life(QoL) in #HFrEF?Analysis of 2 HFrEF registries finds low KCCQ-QoL score is driven by symptoms &social limitations(effect size 0.48-0.60)less by physical limitations alone(effect size=0.34) Findings held across age & sex
ahajournals.org/doi/10.1161/…
🫀 Full quadruple GDMT for US HFrEF:
💊 4 generic pills, ~$25/month ➡️
❤️ ~114K lives saved/year
🏥 ~864K hospitalizations avoided
💰 $16.3Billion net savings
⚠️ Only 18% get all 4
💻 One of the best opportunities in healthcare for AI to improve care, outcomes & cost?
Gregg Fonarow MD retweeted
Practical Implementation of Steroidal and Nonsteroidal Mineralocorticoid Receptor Antagonists in the Management of Heart Failure
Guideline-directed medical therapy is often underutilized in patients with HF.
Consider simultaneous or rapid sequence initiation of a combination therapy for patients with HF with mildly reduced or preserved ejection fraction
@mvaduganathan @gcfmd @CMichaelGibson @SJGreene_md @DrMarthaGulati @HFA_President @GianluSava
jacc.org/doi/10.1016/j.jacad…
Gregg Fonarow MD retweeted
MRAs are effective for #CHF across the entire LVEF spectrum. Guidelines, label indications, & patient comorbidities must be considered when selecting an MRA for GDMT combination therapy regimens. Read the state-of-the-art review in #JACCAdvances!
@GCFMD
bit.ly/4ss6kCi
Gregg Fonarow MD retweeted
💰 The broader annual cost burden of Heart Failure (HF) is projected to reach $858 billion by 2050. Yet, we hold an extraordinarily cost-effective solution in our hands today. See below for more + click here for more insights from our HF STATS 2026 report bit.ly/3ULm2vS
💊Is evolocumab cost-effective before a first MI or stroke?
📊 VESALIUS-CV lifetime model at $3,107/yr
❤️ −0.24 MACE/person
✅ ICER $71,162/QALY; scenarios $20K–$51K
🎯 All below the $120K AHA/ACC threshold
⚠️ Preprint
🔗 doi.org/10.64898/2026.07.23.…
💊 PCSK9 inhibitors in the US, Oct 2026:
💉 Repatha: ~60%↓LDL | CVOT ✅ | $239/mo
💉 Praluent: ~45–60% | CVOT ✅ | $225/mo
🩺 Leqvio: ~50% | CVOT ⏳ | no DTC
💉 Lerochol: ~56–60% | CVOT ❌ | $199/mo
💊 Lipfendra (oral!): ~56–59% | CVOT ⏳ | $315 list
#Lipids
Trial after trial, vitamin D supplements keep coming up empty:
💊 VITAL (25,871): no CV benefit
🧬 83,000 across 21 RCTs: null
💀 80 RCTs: no CV benefit
🩺 SIMPLIFIED (2026, dialysis): no ☠️ benefit, HR 0.94
Billions spent on RCTs
Still nothing
Low D is a marker
Gregg Fonarow MD retweeted
👏 Congratulations go out to Amrut Ambardekar, MD, FHFSA of the University of Colorado Health for being named this year's Distinguished HFSA Service Award winner at #HFSA2026
Learn more 👉 youtube.com/watch?v=T_AGfOX4…
Gregg Fonarow MD retweeted
CMS's 2027 HF model has no measure for MRAs or SGLT2i, and doesn't require ARNI.
Modeled: every eligible U.S. HFrEF patient on all 3 at generic prices (~$227/yr) could prevent ~87.5K deaths and save ~$14.1B net per year.
Keykhaei et al, JACC HF 2026
#HFrEF #Cardiology
💊 Does stopping cardiovascular meds make patients feel better?
🔬 6 deprescribing RCTs, 3,748 older/frail patients
😐 QoL better in just 1 of 5
⚠️ Adverse events reduced: 0 of 6
⚖️ Death/hospitalization better: 0 of 6
🚫 Rarely helpful 😳
#Deprescribing
Gregg Fonarow MD retweeted
🫀 Quadruple guideline-directed medical therapy (GDMT) offers a profound mortality benefit, yet it remains severely underutilized across Heart Failure (HF) care today. Data from HF STATS 2026 reveals only 18% of patients with HFrEF receive all 4 foundational medication pillars.
Gregg Fonarow MD retweeted
🌟🏅Congratulations to the winner of this year's HFSA Distinguished Mentor Award, Lynne Stevenson, MD of Vanderbilt University Health, for her leadership and mentorship in the #HeartFailure field! #HFSA2026
Stay tuned for more award announcements!
Learn more about Lynne Stevenson, MD here 👉 youtube.com/watch?v=sUci1Cgi…
❓for @CMSGov
Why does the 2027 HF ASM measure beta-blockers and RASi 💊 but not ARNI, MRA or SGLT2i?
Those 3 could prevent:
~88K deaths 💔 a year
~746K 🏥 a year
Saving $14.1B 💰, at $227/yr per patient
What are we missing? 🤷
@ACCinTouch @American_Heart @HFSA @AAHFN
Gregg Fonarow MD retweeted
Heart failure care has advanced, but the US burden continues to grow. A new report shows mortality is rising as more Americans are being affected, with obesity, diabetes, and other comorbidities potentially contributing to the trend. #HeartFailure #PublicHealth bit.ly/4rZGy8a
🫀 Ready to make a difference in #HCM care?
The @American_Heart Hypertrophic Cardiomyopathy Registry is enrolling!
📊 National HCM registry
🏆 Hospital QI recognition
📜 Hospital & pro certification
🩺 Patient support
🤖 AI detection pilot
👉 heart.org/hcmregistry
🚑 ICH patients reach the ED faster than those with ischemic stroke (median 127 vs 175 min from last known well)
🧠 But once stroke severity is accounted for, they're LESS likely to meet ED care targets
⏱️ Time is brain for ICH too
📄 Royan et al, doi.org/10.1001/jamanetworko…
💊 Starting HFrEF GDMT:
8 landmark RCTs, 30,523 pts, ~55,600 patient-yrs, 6,725 deaths/HF events
🛑 Stopping GDMT after EF recovery:
5 pilot RCTs, 313 pts, ~300 patient-yrs, surrogates only
⚖️ ~180× less follow-up
📕 Keep GDMT going until real RCTs say otherwise
Gregg Fonarow MD retweeted
GDMT is Associated with Reduced Loop Diuretic Requirements, Whereas Diuretic Dose Does Not Modify GDMT Benefit in Heart Failure: STRONG-HF.
GDMT optimization acted as diuretic-sparing therapy: reaching target doses, particularly of all three classes, was associated with markedly lower LD requirement.
@hfcollaboratory @gcfmd @SJGreene_md @mvaduganathan
academic.oup.com/eurjhf/adva…
