Learn more about this year's Lifetime Achievement Award recipient, Gregg C. Fonarow, MD, FHFSA. 🏆 Dr. Fonarow shares career highlights, his outlook on the future of heart failure care, and advice for those entering the field. Don't miss his award ceremony onsite at #HFSA2026 on Saturday, October 10. 🔗 Read the full spotlight: hfsa.org/lifetime-achievemen…

HFrEF: the 4 pillars are no longer optional. ❤️ The message is simple: quadruple GDMT saves lives. 🔹 ARNI 🔹 Evidence-based beta-blocker 🔹 MRA 🔹 SGLT2 inhibitor All four provide major clinical value, but the SGLT2 inhibitor stands out for tolerability and simplicity, while ARNI and beta-blockers may require more careful titration and monitoring. The goal in 2026 is not sequential therapy over months: 👉 initiate the 4 pillars early, then optimize doses. The biggest remaining challenge? Therapeutic inertia. #HFrEF #HeartFailure #GDMT #SGLT2i #Cardiology

🏨 participation in GWTG-HF associated with ⤴️ GDMT use/outcomes Quality Programs Increase Guideline-Directed Heart Failure Therapy thecardiologyadvisor.com/new… @ATSandhu @American_Heart @AHAScience @AHA_Research @kofi_larry @NMHheartdoc @hvanspall @docsabe @HeartDocSadiya @kejoynt

The biggest opportunity in HFrEF may not be a new drug. It is implementing what we already know works. Only 18.2% of eligible patients receive all 4 foundational GDMT therapies. Optimal implementation could potentially prevent, each year: ➡️ 113,747 deaths ➡️ 357,332 HF hospitalizations We have the evidence. We have the therapies. The remaining challenge is implementation. Closing the GDMT gap may be one of the highest-impact opportunities in modern heart failure care. #HeartFailure #HFrEF #GDMT #Implementation #Cardiology

Phoenix is the place to be from October 9-12! #HFSA2026. Register now, its not too late: HFSA.org/ASM2026

🫀 How should quadruple GDMT for #HFrEF be rated? Efficacy: 5️⃣
Tolerability: 4️⃣
Cost: 5️⃣ (all generic now! 💰)
Convenience: 4️⃣
Value: 5️⃣ 🏆 ARNI + β-blocker + MRA + SGLT2i = arguably the best value in all of cardiology Start all 4, now⏱️

🗞️ Mortality benefit and lifetime survival gains with vericiguat in HFrEF: Bayesian and actuarial analyses of the VICTOR trial @ESC_Journals @GiuseppeGalati_ @AmrAbdin10 @HanCardiomd bit.ly/4cXxAlL

Do HFpEF 💊s benefits vary by adiposity? Finerenone, empagliflozin and dapagliflozin each show a different efficacy by BMI pattern: none significant Finerenone's signal not confirmed by other adiposity indexes HFpEF adipokine hypothesis: challenged 🤔 Rx regardless of BMI

4 🔑 medications Proven to cut deaths in HFrEF Only 18% of eligible patients get all 4 in the US The gap: ~113,747 preventable deaths a year One preventable ☠️ every 4.6 minutes Cost ~$1 day The 💊s exist, the preventable ☠️s don't have to Implement now in every setting

The LDL-C–MH-MARS machine learning equation matched the Martin-Hopkins equation for #LDL_C accuracy and outperformed Friedewald, Sampson-NIH, and Modified Sampson equations in nearly 5 million US patients. ja.ma/3UsW8wz

💊 Quadruple GDMT for HFrEF: Up to 73% ↓ mortality and +7–11 years of life
 Yet only 18.2% get all 4 pillars
 Close the gap → ~113,747 US deaths preventable/year
 Cost? ~$380/yr generic, offsetting ~63× in hospital costs
 Big benefit. Tiny cost. Huge opportunity. ❤️

🫀🔬 "Seeing is believing"… but by how much? 9 RCTs of CAC/CTA-guided prevention: Showing patients their plaque nudges statin/antiplatelet use up ~10 pp and trims LDL only by fractions of an mmol/L Modest moves And so far, no ⬇️ in hard CV events in RCTs 👀➡️🤷

📝 Viewpoint: #CoronaryComputedTomographyAngiography plaque analysis has prognostic value, but current evidence does not support its use as a screening tool for asymptomatic adults. ja.ma/4xrWaCo

📊 Among adults with cardiovascular disease and overweight or obesity without diabetes, #Semaglutide showed cardiovascular benefit across levels of #Frailty, with no clear evidence that frailty reduced treatment efficacy. ja.ma/4yGZMla

How can clinicians continue improving cardiovascular outcomes? @GCFMD weighs in. 📖 Read more: cardiocaretoday.com/post/qa-… #Cardiology #HeartFailure #CVMed

The global epidemiology of heart failure: a comprehensive and contemporary review Heart failure: a growing global epidemic we cannot ignore. ❤️ 55+ million people affected worldwide 📈 Prevalence continues to rise with aging populations ⚠️ Lifetime risk approaches 1 in 4 🏥 ~30% hospitalized again within 1 year 📉 Despite improved survival, 5-year mortality remains ~40% 💰 Global costs: $284 billion, with major inequalities in their distribution The challenge is no longer only to treat HF—it is to prevent it, diagnose it earlier, implement guideline-directed therapy faster, and reduce disparities in care. Heart failure is not just a cardiac disease. It is a global public-health challenge. #HeartFailure #Cardiology #HFpEF #HFrEF #Prevention #GDMT #GlobalHealth #ESC academic.oup.com/eurjhf/arti…

Excellent commentary by Drs. @AndrewOseran and @prihatha on our recent study in @JACCJournals. Beyond the four foundational pillars of HFrEF therapy, they emphasize policy as the critical “fifth pillar”, bridging the gap between what evidence recommends and what patients actually receive. 💊🏛️🫀 @gcfmd @ATSandhu @SJGreene_md @DOM_UCLA @uclaCVfellows @DOM_UCLA sciencedirect.com/science/ar…

New Quality and Implementation Science Track at EPI 2027 Submit abstracts and attend! @kejoynt @dmljmd @jspertus @AHAScience @AHA_Research @docsabe @rkwadhera @kardiologykazi @kofi_larry @NMHheartdoc @HeartDocSadiya

🥗❤️ Most major U.S. dietary RCTs for heart disease = null: 🫒 LA Veterans '69: mixed 
🧠 Minnesota: null 
🚬 MRFIT '82: null 
🧂 DASH '97: ↓BP only 
👩 WHI '06: null 
⚖️ Look AHEAD '13: null Diet (tested so far) shifts risk factors a bit, hard CV events? Not so much ☹️

Its like saying 1990s era chemotherapy / radiation for cancer is "good care" in 2026 -- We need to do better for patients suffering from heart failure. @gcfmd @NMHheartdoc @SJGreene_md @DrMarthaGulati