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Gregg Fonarow MD @gcfmd
Joined December 2012
  • Tweets 11,406
  • Following 163
  • Followers 12,168
2,134 Photos and videos
Sisyphean Task of Cardiovascular Prevention: Real Gains, Unequal Progress | Circulation ahajournals.org/doi/10.1161/… @boback @kewatson @CircAHA

Sisyphean Task of Cardiovascular Prevention: Real Gains, Unequal Progress | Circulation

ahajournals.org
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A system for AI guided remote initiation, titration, and monitoring of GDMT ➡️ 📈 Improved GDMT composite score ⏱️ Timely dose optimization ⚖️ High rates of recommendations being acted on ❤️‍🩹 Associated with ⬇️ HF 🏨s Usual Care Minimal improvement doi.org/10.1016/j.jchf.2025.…
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Gregg Fonarow MD retweeted
Ahmed Bennis MD 🫀@drbennisahmed
20h
Groundbreaking results from the TEAM-HF ✅ 4-drug GDMT use jumped from 21% → 88% in the GDMT Clinic (4.2× increase) ✅ Optimized in ~16 weeks (3–6 visits) ✅ 76% still on 4-drug GDMT at 6-month follow-up Vs. usual care: 0.0× increase 😬
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Gregg Fonarow MD retweeted
JAMA Cardiology@JAMACardio
Jun 14
Quadruple guideline-directed medical therapy in #HeartFailure with reduced ejection fraction was projected to offset hospitalization costs by nearly $10 000 per patient-year, frequently yielding net health care savings. ja.ma/4vJj9Z8
Bar chart of 2021 mean 1-year costs ($) for hospitalization types: All cause, HF, CV, and Total cost. Costs are consistently highest for 'No GDMT', lower for 'Partial GDMT', and lowest for 'Optimal GDMT' across all types. E.g., Total cost for 'No GDMT' is ~$56K, 'Partial GDMT' ~$41K, 'Optimal GDMT' ~$32K.

ALT Bar chart of 2021 mean 1-year costs ($) for hospitalization types: All cause, HF, CV, and Total cost. Costs are consistently highest for 'No GDMT', lower for 'Partial GDMT', and lowest for 'Optimal GDMT' across all types. E.g., Total cost for 'No GDMT' is ~$56K, 'Partial GDMT' ~$41K, 'Optimal GDMT' ~$32K.

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GDMT focused outpatient clinics can rapidly, safely, and efficiently ➡️ ✅ 88% quadruple GDMT use 🎯 dosing ⤴️ 📈 adherence ⤴️ ❤️‍🩹 rapid clinical benefits Routine care at one the most renowned health systems ➡️ 😱 1% quadruple GDMT use Stunning! doi.org/10.1016/j.jchf.2024.…
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Quadruple GDMT can be simultaneously initiated rapidly uptitrated in ambulatory outpatients ✅ Time to quadruple GDMT optimization 29 days ✅ Safe, well tolerated, efficient Benefits: ☠️ ⬇️ RR 72.9% 🏥 HF ⬇️ RR 85% Extend survival 7-11 years At a 💊 cost of only ~1 a day
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😱 US #HeartFailure mortality is still going ⤴️⤴️⤴️ 💔 425,147 HF related ☠️ (45% of all CV ☠️) in 2023 🆘 Yet, massive gaps in GDMT use and HF prevention efforts Fight back: 🎯 Prevention 🎯Treatment 🎯 Implementation NOW #Cardiology #GDMT @ACCinTouch @American_Heart @HFSA
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Despite full access to quadruple GDMT at no or very low out of pocket cost….. Fewer than one in four patients with HFrEF received quadruple GDMT over 2.9 years of follow-up Vital need to improve care and outcomes for HFrEF
JAMA Cardiology@JAMACardio
Jun 13
Among US veterans with #HeartFailure with reduced ejection fraction, fewer than one-quarter achieved quadruple guideline-directed medical therapy within 2.9 years, and medication copays were associated with lower rates of therapy achievement. ja.ma/4ekr9Jf
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💔 Suboptimal uptake of pharmacological treatments in newly diagnosed patients with HF ➡️ Poor prognosis 🎯 Critical to improve implementation of evidence-based therapies within each LVEF subtype nature.com/articles/s41598-0…

Pharmacological treatments and clinical events in newly diagnosed heart failure patients stratified...

Scientific Reports - Pharmacological treatments and clinical events in newly diagnosed heart failure patients stratified by ejection fraction in Japan

nature.com
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UCLA-led study finds guideline-directed medical therapy may lower hospitalization-related costs @MKeykhaeiMD @boback @UCLAHealth @UCLAHealthNews @DOM_UCLA @ATSandhu @MKIttlesonMD @NMHheartdoc @HeartNews @JAMACardio uclahealth.org/news/release/…

UCLA-led study finds guideline-directed medical therapy may lower hospitalization-related costs

Patients hospitalized with a common form of heart failure could avoid later hospital stays – and dramatically lower health care costs – if they receive the full combination of four medications...

uclahealth.org
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Would ~$1 a day in medication cost for HFrEF be considered of sufficient value if it resulted in an average of $26 to $63 a day in reduced healthcare expenditures? @HFSA @ACCinTouch @American_Heart @AAHFN @JAMACardio jamanetwork.com/journals/jam…
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❤️‍🩹 HFrEF 💊 ARNI BB MRA SGLT2i 🚀 Ultrafast clinical benefits ☠️ ⬇️⬇️⬇️⬇️ 🏨 ⬇️⬇️⬇️⬇️ ⚖️ HRQOL ⤴️ 🪎 Amazing value 🆘 < 2 in 10 eligible treated ❌ Delaying/omitting quadruple GDMT causes preventable ☠️s, 🏨s, and financial toxicity
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Gregg Fonarow MD retweeted
Ahmed Bennis MD 🫀@drbennisahmed
Jun 12
New data: Switching HFrEF patients from no therapy fully generic optimal GDMT cuts projected hospitalization costs by $22,549 (58%) per patient per year. Even from today’s partial care, full optimization saves $6,240–$8,556/patient/year. Quadruple therapy works
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Gregg Fonarow MD retweeted
Ahmed Bennis MD 🫀@drbennisahmed
Jun 12
Optimal GDMT doesn’t just save lives — it saves money across every hospitalization category. Mean 1-year costs vs. No GDMT: All-cause hosp: $39K → $15K HF hosp: $17K → $2K CV hosp: $28K → $4K Total (Parts A B): $56K → $32K Even partial GDMT costs MORE than optimal
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Gregg Fonarow MD retweeted
Mohammad Keykhaei, MD, MPH
@MKeykhaeiMD
Jun 12
Lower prices could make the value of quadruple GDMT even more compelling 💊📉 At current Cost Plus Drugs cash prices, generic/priced options for HFrEF therapy may cost ~$31/month , about $380/year. This could further amplify the hospitalization cost-offset of optimal GDMT. @gcfmd @SJGreene_md
JAMA Cardiology@JAMACardio
Jun 11
Quadruple guideline-directed medical therapy in #HeartFailure with reduced ejection fraction was projected to offset hospitalization costs by nearly $10 000 per patient-year, frequently yielding net health care savings. ja.ma/4eyMQ9I
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Gregg Fonarow MD retweeted
JAMA Cardiology@JAMACardio
Jun 11
Quadruple guideline-directed medical therapy in #HeartFailure with reduced ejection fraction was projected to offset hospitalization costs by nearly $10 000 per patient-year, frequently yielding net health care savings. ja.ma/4eyMQ9I
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HFrEF Step 1: Implement and optimize dosing of quadruple GDMT (ARNI BB MRA SGLT2i) Cost $380/yr Step 2: Save 💵 ~$22K per yr vs no GDMT ~$10K per yr vs ACEI BB jamanetwork.com/journals/jam… @MKeykhaeiMD @NMHheartdoc @SJGreene_md @ATSandhu @MKIttlesonMD @JAMACardio @JAMA_current

Cost Offset With Quadruple Therapy for Heart Failure

This economic evaluation examines Medicare-linked registry data to estimate the 1-year health care cost offset and net cost associated with using quadruple guideline-directed medical therapy after...

jamanetwork.com
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Now available at a monthly cost of only $14.40
American Association of Heart Failure Nurses@AAHFN
Jun 10
AAHFN In the Know A decade of real-world experience with sacubitril/valsartan (Sac/Val) continues to reinforce what clinical trials first revealed: Sac/Val remains a cornerstone therapy for patients with HFrEF. Read more: doi.org/10.1093/eschf/xvag09…
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Gregg Fonarow MD retweeted
Ahmed Bennis MD 🫀@drbennisahmed
Jun 11
Quadruple GDMT for HFrEF at generic pricing costs just $380/year. 📉 vs partial GDMT (2 drugs): saves ~$9,400/patient/year 📉 vs no therapy: saves ~$23,400/patient/year That’s a 26–63× return on every dollar spent on meds Barriers to prescribing GDMT are running out of excuses.
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Cost Offset With Quadruple Therapy for Heart Failure jamanetwork.com/journals/jam…… @MKeykhaeiMD @NMHheartdoc @SJGreene_md @ATSandhu @MKIttlesonMD @JAMACardio @JAMA_current
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