ViralTopic

quadruple GDMT underuse in HFrEF

April 4, 2026Gregg Fonarow MD

Gregg Fonarow MD says HFrEF care still relies on ACEI/ARB plus beta blocker despite Class 1 recommendations for quadruple GDMT, arguing ARNI plus beta blocker plus MRA plus SGLT inhibitor meaningfully extends survival for about $70 more per month.

Most common Rx is use still ACEI/ARB+BB, despite Class 1 recommendation for quadruple GDMT
ACEI/ARB+BB ➡️ ARNI+BB+MRA+SGLTi
Extends median survival: 6.3 years
💊s cost extra $70 per month
Worth it?
Gregg Fonarow MD
cardiologyguidelinescost

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