Los Angeles, CA
Joined December 2012
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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…
🧠 New in @JAMANetworkOpen: ICH vs ischemic stroke in 195,659 EMS arrivals
GWTG-Stroke, 2015–24
🚑 ICH patients arrive at the ED faster
⏱️ But once adjusting for stroke severity, they're LESS likely to hit ED targets (MD ≤10 min, imaging ≤20 min)
Time is brain for ICH too!
Timeliness of Emergency Care for Intracerebral Hemorrhage Compared With Acute Ischemic Stroke
doi.org/10.1001/jamanetworko…
@AHAScience @AHA_Research @JAMANetworkOpen @JAMA_current @Braindoc_MGH @VCI_EricSmith @American_Stroke #GWTG
🫀📡 New in JACC: Heart Failure:
AI-guided monitoring after HF discharge was feasible, but didn't cut re-🏨 or ED visits/readmission/death
🏥 5 VA centers | 🩹 chest patch up to 90 days
Feasible ≠ effective
📉❌
#HeartFailure #DigitalHealth
@JACCJournals
🫀 Heart failure contributes to ~1 in 7 US deaths (457K/year)
💵 NIH $ per death:
🧬 HIV ~$717K
🧠 Alzheimer's ~$31K
🎗️ Cancer ~$13K
🫁 COPD ~$824
❤️🩹 HF ~$440 (est.)
HF gets ~1,600× less than HIV per death
Fund HF research!!!📢
@HFSA @ACCinTouch @American_Heart
🫀 HF by stage (US):
🟢 A: ~80M at risk, ~0.6%/yr mortality
🟡 B: ~60–85M, ~0.8%/yr
🟠 C: ~7.2M, ~6–10%/yr
🔴 D: ~0.5M, 30–50%+/yr
Mortality jumps ~10x once HF symptoms start
🛡️ Prevent HF in Stage A/B
💊 Get Stage C pts on full GDMT, now!
Gregg Fonarow MD retweeted
🔓 For a limited time until October 25, we are offering free promotional access to a new article in #CJC!
This study leverages the TriNetX research network to evaluate the clinical effectiveness of GLP 1 RAs in patients with diabetes or obesity undergoing TAVR.
• At 1 year follow up, GLP 1 RA use was associated with a lower risk of multiple cardiovascular outcomes, including MACE and all-cause mortality, compared with non users.
• These findings are hypothesis generating for GLP 1 RAs as adjunctive therapy, in addition to guideline directed medical therapy, in patients undergoing TAVR.
Read here ⬇️
onlinecjc.ca/article/S0828-2…
Gregg Fonarow MD retweeted
📌452,573 Deaths: In 2023, HF contributed to nearly half a million deaths nationwide.
📌14.6% of All Mortality: HF played a role in 14.6% of all-cause deaths across the U.S. in 2023.
📌37% Rate Increase: Age-adjusted HF mortality rose from 123.1 to 168.1 per 100,000 from 2010-23.
📱💊 2 RCTs: remote digital titration of HFrEF meds beats usual care
🔴 VITAL-HF (n=178): +0.78 on GDMT score vs usual care (p=0.007)
🔵 AIM-POWER (n=122): on all 4 GDMT classes at 90d, 48% vs 21%
✅ No excess safety events
📄 Lancet Reg Health Am & Circ Heart Fail 2026
💔 2023: HF contributed to 452,573 US deaths
14.6% of ALL ☠️ (~1 in 7)
That's ~half the number of all CV ☠️ (915,973) 🫀
Yet HF is coded out of 'leading cause' rankings 📋, has no owner & no GDMT accountability 💊
Why isn't this a national priority? 🚨
#HFStats2026
🚨 US HF mortality: 105→81.5 (1999–2012)
then a 12-yr climb back to ~101/100k, peaking at 106 in 2021 📈💔
We have more effective GDMT than ever 💊 yet the curve reversed for a decade
How in the world was this allowed without an intensive, urgent response? 🤔
#HFStats2026
📊 HFrEF mortality, 20 years
🧪 Trial placebo arms (1991→2010): total mortality 10.3→3.8 (−63%), cardiac 33.1→9.9 (−70%) 📉
🏥 Community practice (1987→2001): 5-yr survival barely budged, ~2/3 dead by year 5 😬
Same disease, same era
Why the gap? 🤔
#HFrEF
243,510 patients with newly diagnosed HF:
15.4% started an sMRA 😳
📉 HFrEF 29.6% | HFmrEF 14.0% | HFpEF 9.5%
🩺 Lowest uptake: HFpEF
🚨 <1 in 3 w/ HFrEF Rx with sMRA
💔 Do better for patients with HF!
🔗 doi.org/10.1016/j.cardfail.2…
@JCardFail @lamcardio
Gregg Fonarow MD retweeted
Among patients with #AtrialFibrillation, catheter-based #LeftAtrialAppendageClosure had similar overall stroke and major bleeding rates vs oral anticoagulation, but higher ischemic stroke risk and lower nonprocedural major bleeding. ja.ma/4B52fYv