Tricia Hagedorn

Passionate, energetic being who finds fulfillment in meaningful connections, learning, creating new things, & staying curious.

[Tricia Hagedorn @Triciahagedor20]

@panagis21 🙏🏻

[Tricia Hagedorn @Triciahagedor20]

@panagis21 @JHUPress definitely want a copy

[Tricia Hagedorn @Triciahagedor20]

The Last Mile of Cardiovascular Prevention: Evidence, Access, and Policy | Circulation https://t.co/a41uuO2JjT

[Gregg Fonarow MD @gcfmd]

🫀 Quadruple GDMT for HFrEF is one of the great wins in cardiology, yet adoption lags badly 😔

The evidence has been here for years:

🔴 Beta-blocker (1996): ↓35% mortality
🟠 ARNI (2014): ↓28%
🟢 MRA (1999): ↓30%
🟣 SGLT2i (2019): ↓17%

Together: 72.9% RRR, NNT = 4 📉

[Gregg Fonarow MD @gcfmd]

💔 HFrEF

🧯 Markedly reduce the early window of vulnerability

❤️‍🩹 Achieve rapid clinical stabilization

🥅 Obtain substantial early ⬇️ in 🏨/☠️

ARNI+BB+MRA+SGLT2i from Day 1

Win-win-win-win

[Gregg Fonarow MD @gcfmd]

Among older patients 🏨 for HFrEF eligible for GDMT

HF steals as much as 16.3 years of median survival

Quadruple GDMT (ARNI+BB+MRA+SGLT2i) can give years of survival back, but only if prescribed

Worth overcoming therapeutic inertia?

https://t.co/TAbhQL11kH

[Gregg Fonarow MD @gcfmd]

Evidence to routine clinical practice:

💔 BB ☠️⬇️ evidence since 1996, yet 27% of eligible patients not treated

🤬 MRA ☠️⬇️ evidence since 1999, yet 64% of eligible patients no Rx

🫣 SGLT2i ☠️⬇️ evidence since 2019, yet 66% of eligible patients no Rx

Delay, delay, delay

🆘

[Gregg Fonarow MD @gcfmd]

The 2022 AHA/ACC/HFSA guidelines are explicit in recommending that patients with HFrEF be treated with each of the 4 classes of foundational, disease-modifying, survival-enhancing GDMT as Step 1 of care, in the absence of contraindications

[Andrew J Sauer MD @AndrewJSauer]

Cardiometabolic disease does not fit neatly into silos, and our care models should not either.

I am proud that Saint Luke’s Mid America Heart Institute is part of the new CHROME initiative, a national multisite effort launched with the AMCP Research Institute to evaluate how comprehensive cardiometabolic care models work in the real world, including their clinical impact, operational structure, patient and provider experience, and economic value.

This is exactly the kind of work the field needs.

We already know that many evidence-based therapies can improve outcomes in obesity, diabetes, cardiovascular disease, kidney disease, and related conditions. The harder question is how to organize care so the right patients are identified earlier, treatment is started more effectively, multidisciplinary care is sustained, and health systems and payers can realistically support it at scale. CHROME is designed to help answer those questions.

At Saint Luke’s Mid America Heart Institute, through the Michael & Marlys Haverty Cardiometabolic Center of Excellence, we have been committed to building and studying practical care models that improve diagnosis, treatment uptake, and long-term outcomes. Our participation in CHROME reflects that mission and gives us an opportunity to help shape the evidence base for what modern cardiometabolic care should look like.

What makes this initiative especially important is that it goes beyond clinical endpoints alone. CHROME will also examine governance, staffing, referral pathways, treatment protocols, diagnostic workflows, patient experience, provider workflows, payer decision-making, and implementation barriers.

That is where scalable care models either succeed or fail.

I am grateful to partner with AMCP Research Institute, Lilly, Geisinger, and the Patient Advocate Foundation’s Patient Insight Institute on this effort. If we want to close the gap between evidence and execution in cardiometabolic care, this is the kind of work that matters.

https://t.co/tH9aAp2u0g

[John P Erwin III MD MBA MACC (#BigPoppy ) @HeartOTXHeartMD]

RIP to a giant in Cardiology!😢🙏🏼

Dr Braunwald was one of a kind!

[Ahmed Bennis MD 🫀 @drbennisahmed]

💊🫀 What does optimal therapy actually buy a 65-year-old with HFmrEF/HFpEF?
From Nature Medicine (Vaduganathan et al., 2025):
🔴 SGLT2i + nsMRA → +3.6 years event-free survival
🔴 SGLT2i + nsMRA + ARNI → +4.9 years (LVEF <60%)
vs. standard therapy alone.
Nearly 5 extra years without hospitalization or death.
💡 These drugs exist. They work. Are all eligible patients receiving them?
Vaduganathan et al. Nature Medicine, Oct 2025
@mvaduganathan

#HeartFailure #HFpEF #HFmrEF #SGLT2i #ARNI #Cardiology #MedTwitter #NatureMedicine

[Gregg Fonarow MD @gcfmd]

Only 9% of eligible HFrEF patients were on quadruple GDMT

The treatment nihilists said it couldn’t be done — “too many meds, too much hassle”

But relentless work through GWTG‑HF has changed this

We’re now at 68.1%

This is what progress looks like💥❤️‍🩹

https://t.co/tf1QtvH5Rs

[Gregg Fonarow MD @gcfmd]

Worldwide red alert🚨

HF attributed ☠️ ⤴️⤴️⤴️

Critical to prioritize prevention and improved treatment of HF globally

Effective evidence-based strategies/therapies exist and are guideline recommended, yet massive implementation gaps, variations, and disparities

[Tricia Hagedorn @Triciahagedor20]

@rohan_khera such a nice remembrance and so sorry for your loss. May his spirit continue to live though all you do.

[Muthu Vaduganathan @mvaduganathan]

#GDMT has now arrived for #HFpEF

#SGLT2i (class I) and #nsMRA (class IIa) recommendations in initial global guidelines

https://t.co/PToRoHmz4D

#HeartFailure2025

[Tricia Hagedorn @Triciahagedor20]

@iamritu @BritoCardio @rafavidalperez @NaturePortfolio @mmamas1973 @NatureMedicine @ASE360 @mswami001 @DavidWienerMD @rajdoc2005 @CASivaram1 @EACVIPresident @denisamuraru @purviparwani @AHAScience this mildly breaks my heart. ❤️ but so true!

[Tricia Hagedorn @Triciahagedor20]

@DrNikkiBart @BrighamWomens @TIMIStudyGroup @bbikdeli @harvardmed @escardio @BrighamFellows @mapabonp @DrMarthaGulati wow, so incredible! ❤️

[Tricia Hagedorn @Triciahagedor20]

@ProfRScolyerMIA That’s fantastic!! 🙏🏻

[Tricia Hagedorn @Triciahagedor20]

Seriously , how I wish I was in the room for this lecture! @spencerrascoff