Jonathan Davis, MD, MPHS

The 3 rules of #GDMTWorks for #HFrEF: 1. Start more 2.⬆️doses 3. Keep them going #QuadTherapy: BB + ARNI + MRA + SGLT2-I. 75% RR reduction w NNT of <4!! @gcfmd @MKIttlesonMD @AndrewJSauer @AminYehyaMD @mpsotka @DrNasrien @shwinner @ShelleyZieroth @iamritu @DevinMehta @datsunian

@UCSFCardiology @UCSF @UCSFHospitals Congratulations! I wish all of you the very best!

Congratulations to our 2026 @UCSF cardiology fellowship and advanced fellowship graduates! We’re excited to see all that you will accomplish. Thank you for your dedication to caring for patients and excellence you bring to our profession. #UCSFCardiology #UCSFGrads @UCSFHospitals

❤️‍🩹 Heart failure 💊 SGLT inhibitors 🚀 Ultrafast clinical benefits (across the EF spectrum) 🪎 Amazing value 🛎️ What are you waiting for?

Is the simultaneous/rapid sequence initiation strategy for GDMT for HFrEF superior to usual care one by one approach? ✅ Better use, dosing, adherence, and persistence ✅ Safe, well tolerated, less HF events In both the 🏨 and outpatient clinic setting 🎯STRONG-HF 🎯 SHORT

Can quadruple GDMT be simultaneously initiated and rapidly uptitrated in ambulatory outpatients with HFrEF? The SHORT RCT ✅ Time to quadruple GDMT optimization 29 days vs 112 with usual care ✅ safe, well tolerated, less visits, less HF events jacc.org/doi/10.1016/j.…

Rosuvastatin 20 mg for primary prevention and achieving LDL < 50 mg/dL Clinical benefits>>potential risks Relative risk reductions: large Absolute risk reductions: small per year, but accumulate over time Cost: $31.40 per year $2.61 per month 9 cents a day

💊🫀 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

Every admission = opportunity to improve #GDMTWorks! MD, RN, PharmD, etc; QD-BID labs; vitals 4-6x/day... all hands on deck! Take advantage! Major consequences of stopping or not starting! @SJGreene_md @mvaduganathan @gcfmd @JavedButler1 @UCSFIMChiefs 10.1016/j.jchf.2018.06.011

Ten Years Real-World Experience With Sacubitril/Valsartan in Patients With Heart Failure With Reduced Ejection Fraction see @ESC Heart Failure ow.ly/zovq50YKIO1 @EJHFEiC @JanBiegus @Ppponikowski #HFA_ESC @hvanspall @ShelleyZieroth @FudimMarat @gcfmd @MarcoMetra @GianluSava #ESCHeartFailure

Why are 100% of eligible patients with HFrEF w/o CI or intolerance not receiving quadruple GDMT in 2026? ARNI+BB+MRA+SGLT2i ➡️ 75% ⬇️ all-cause ☠️ (26% ARR, NNT=4, 24 months) 85% ⬇️ HF 🏨 (33% ARR, NNT=3, 24 months) Extend median survival by 7-11 years 💊 Cost $78/month

@evivemmou @UCSFCardiology @CCAD_MHIF @ACCinTouch Love this photo! Sorry I missed you there. Hope you're all doing well!

Had a blast 🚀at #ACC2026 Grateful to present regarding coronary vasospasm as a cause of cardiac arrest, learn with my co-fellows and seeing old friends and mentors 🫀 @UCSFCardiology @CCAD_MHIF @ACCinTouch

Patients newly diagnosed w/ #HFrEF >9 of 10 deaths occur among pts who never receive ≥1 💊 proven to ⤵️⤵️⤵️death.... ...in a nationwide health system w/ minimal or $0 patient copays for #GDMTworks 🤯🤯🤯 @gcfmd @JavedButler1 jamanetwork.com/journals/jamac…

@SJGreene_md @JavedButler1 @DCRINews @AndrewJSauer @AndrewPAmbrosy @ShelleyZieroth @HanCardiomd @ValleAlfonso @drbennisahmed @JLHarrington_MD @ShashankSinhaMD @DukeCardFellows Treatment inertia, misperception of clinical risk, and lack of therapeutic urgency are highly lethal in HFrEF Take action now!

HFrEF in 2026 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 75.6 months 2300 days 55,188 hours 3,311,280 minutes 💊s cost extra $70 per month Worth it?

Thankful for my coauthors: Jose Lopez, Andrew Sauer, Jonathan Davis, Nasrien Ibrahim, Rod Tung, Biykem Bozkurt, Gregg Fonarow, and Sana Al-Khatib. Link: sciencedirect.com/science/articl…

Considerations for Rx beyond the foundational 4 pillars of disease modifying guideline-directed medical therapy for HFrEF

Excited to share this news piece about one of our #heartsuccess patients in our Heart Failure Clinic @mercysaintlouis, setting the standard for #heartfailure care in the @STLCounty @STLCityGov region @American_Heart @ACCinTouch @HFSA youtu.be/8u6CGTniZNY?si…

I am speaking at UCSF 29th Annual Management of the Hospitalized Patient. Please check out my talk if you're attending the event! #Bob_Wachter #MHP2025 - via #Whova event app

@AndrewFoy82 @gcfmd @mvaduganathan @AndrewJSauer @dranulala @ShelleyZieroth @JavedButler1 @pedschwartzmann @JonathanDavisHF @HFA_President @ankeetbhatt To Mandrola's original point: 🔑is definition of "decompensated" We should not initiate BB in hemodynamic instability/shock But "decompensated" is not synonymous w/ entirety of a HF hospitalization. In-hospital/pre-discharge initiation BB is evidence-based routine approach.

Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction jamanetwork.com/journals/jama/…

Excited to formally launch our #HeartFailure Clinic at @FollowMercy St. Louis. Offering comprehensive, state-of-the-art, guideline-direct care for anyone with heart failure across the ejection fraction spectrum! #heartfunction #heartsuccess