Gregg C Fonarow


Affiliation: University of California
Country: USA


  1. Fonarow G, Smith E, Saver J, Reeves M, Hernandez A, Peterson E, et al. Improving door-to-needle times in acute ischemic stroke: the design and rationale for the American Heart Association/American Stroke Association's Target: Stroke initiative. Stroke. 2011;42:2983-9 pubmed publisher
  2. Pandey A, Gersh B, McGuire D, Shrader P, Thomas L, Kowey P, et al. Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry. JACC Clin Electrophysiol. 2016;2:355-363 pubmed publisher
    ..Although AF patients with higher BMI were significantly younger, higher BMI in AF patients was associated with similar or better clinical outcomes. ..
  3. Man S, Zhao X, Uchino K, Hussain M, Smith E, Bhatt D, et al. Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States. Circ Cardiovasc Qual Outcomes. 2018;11:e004512 pubmed publisher
    ..This information may be important for acute stroke triage and targeted quality improvement. ..
  4. Greene S, Butler J, Albert N, DeVore A, Sharma P, Duffy C, et al. Medical Therapy for Heart Failure With Reduced Ejection Fraction: The CHAMP-HF Registry. J Am Coll Cardiol. 2018;72:351-366 pubmed publisher
    ..Strategies to improve guideline-directed use of HFrEF medications remain urgently needed, and these findings may inform targeted approaches to optimize outpatient medical therapy. ..
  5. Jalnapurkar S, Zhao X, Heidenreich P, Bhatt D, Smith E, DeVore A, et al. A Hospital Level Analysis of 30-Day Readmission Performance for Heart Failure Patients and Long-Term Survival: Findings from Get With The Guidelines-Heart Failure. Am Heart J. 2018;200:127-133 pubmed publisher
    ..There is a compelling need to utilize more meaningful and patient-centered outcome measures for reporting and incentivizing quality care for HF. ..
  6. Ziaeian B, Zhang Y, Albert N, Curtis A, Gheorghiade M, Heywood J, et al. Clinical effectiveness of CRT and ICD therapy in heart failure patients by racial/ethnic classification: insights from the IMPROVE HF registry. J Am Coll Cardiol. 2014;64:797-807 pubmed publisher
    ..Device therapies should be offered to eligible heart failure patients, without modification based on race/ethnicity. ..
  7. Gordin J, Fonarow G. New medications for heart failure. Trends Cardiovasc Med. 2016;26:485-92 pubmed publisher
  8. Kolte D, Khera S, Aronow W, Palaniswamy C, Mujib M, Ahn C, et al. Regional variation in the incidence and outcomes of in-hospital cardiac arrest in the United States. Circulation. 2015;131:1415-25 pubmed publisher
    ..Further studies are needed to identify other potential factors responsible for these regional differences to improve outcomes after IHCA. ..
  9. request reprint
    Fonarow G, Abraham W, Albert N, Stough W, Gheorghiade M, Greenberg B, et al. Association between performance measures and clinical outcomes for patients hospitalized with heart failure. JAMA. 2007;297:61-70 pubmed
    ..Additional measures and better methods for identifying and validating heart failure performance measures may be needed to accurately assess and improve care of patients with heart failure. ..

More Information


  1. Echouffo Tcheugui J, Kolte D, Khera S, Aronow H, Abbott J, Bhatt D, et al. Diabetes Mellitus and Cardiogenic Shock Complicating Acute Myocardial Infarction. Am J Med. 2018;131:778-786.e1 pubmed publisher
    ..5%; aOR 1.19; 95% CI, 1.07-1.33; P = .001). In a large cohort of acute myocardial infarction patients, preexisting diabetes was associated with an increased risk of cardiogenic shock and worse outcomes in those with cardiogenic shock. ..
  2. Ziaeian B, Sharma P, Yu T, Johnson K, Fonarow G. Factors associated with variations in hospital expenditures for acute heart failure in the United States. Am Heart J. 2015;169:282-289.e15 pubmed publisher
  3. Fischer C, Steyerberg E, Fonarow G, Ganiats T, Lingsma H. A systematic review and meta-analysis on the association between quality of hospital care and readmission rates in patients with heart failure. Am Heart J. 2015;170:1005-1017.e2 pubmed publisher
    ..Further research is needed to clarify whether the readmission rate is a reflection of hospital care or quality of care on a larger level, especially when it is used for a pay-for-performance scheme to measure quality of hospital care. ..
  4. Golwala H, Pandey A, Ju C, Butler J, Yancy C, Bhatt D, et al. Temporal Trends and Factors Associated With Cardiac Rehabilitation Referral Among Patients Hospitalized With Heart Failure: Findings From Get With The Guidelines-Heart Failure Registry. J Am Coll Cardiol. 2015;66:917-26 pubmed publisher
    ..Further strategies to improve physician and patient awareness in regard to the benefit of CR should be used to increase CR referral among patients with HF. ..
  5. Ziaeian B, Fonarow G. The Prevention of Hospital Readmissions in Heart Failure. Prog Cardiovasc Dis. 2016;58:379-85 pubmed publisher
    ..While evidence-based therapies for HF management have proliferated, the consistent implementation of these therapies and development of new strategies to more effectively prevent readmissions remain areas for continued improvement. ..
  6. Fonarow G, Reeves M, Zhao X, Olson D, Smith E, Saver J, et al. Age-related differences in characteristics, performance measures, treatment trends, and outcomes in patients with ischemic stroke. Circulation. 2010;121:879-91 pubmed publisher
    ..Performance measure-based treatment rates improved substantially over time for ischemic stroke patients in all age groups, resulting in smaller age-related treatment gaps. ..
  7. Echouffo Tcheugui J, Kolte D, Khera S, Bhatt D, Fonarow G. Comparison of Survival After In-Hospital Cardiac Arrest in Patients With Versus Without Diabetes Mellitus. Am J Cardiol. 2018;121:671-677 pubmed publisher
    ..82). Patients with DM had lower odds of being discharged home with self-care after surviving an IHCA (p <0.001). In conclusion, preexisting DM was associated with a modestly lower risk-adjusted chance of survival after an IHCA. ..
  8. Fonarow G, Reeves M, Smith E, Saver J, Zhao X, Olson D, et al. Characteristics, performance measures, and in-hospital outcomes of the first one million stroke and transient ischemic attack admissions in get with the guidelines-stroke. Circ Cardiovasc Qual Outcomes. 2010;3:291-302 pubmed publisher
  9. Dei Cas A, Khan S, Butler J, Mentz R, Bonow R, Avogaro A, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail. 2015;3:136-45 pubmed publisher
    ..This paper discusses the role of DM in HF patients and underscores the potential need for the development of targeted therapies. ..
  10. Ziaeian B, Heidenreich P, Xu H, DeVore A, Matsouaka R, Hernandez A, et al. Medicare Expenditures by Race/Ethnicity After Hospitalization for Heart Failure With Preserved Ejection Fraction. JACC Heart Fail. 2018;6:388-397 pubmed publisher
    ..Minority patients with HFpEF have greater acute care service costs. Further research of improving care delivery is needed to reduce acute care use for vulnerable populations. ..
  11. Cheng R, Cox M, Neely M, Heidenreich P, Bhatt D, Eapen Z, et al. Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population. Am Heart J. 2014;168:721-30 pubmed publisher
    ..Irrespective of EF, these patients experience substantial mortality and readmission highlighting the need for new therapeutic strategies. ..
  12. Shore S, Grau Sepulveda M, Bhatt D, Heidenreich P, Eapen Z, Hernandez A, et al. Characteristics, Treatments, and Outcomes of Hospitalized Heart Failure Patients Stratified by Etiologies of Cardiomyopathy. JACC Heart Fail. 2015;3:906-16 pubmed publisher
    ..83; 95% confidence interval: 0.71 to 0.97). Characteristics of hospitalized HF patients vary by etiology. Both risk-adjusted quality of care and in-hospital outcomes did not differ by etiology. ..
  13. Pandey A, Golwala H, DeVore A, Lu D, Madden G, Bhatt D, et al. Trends in the Use of Guideline-Directed Therapies Among Dialysis Patients Hospitalized With Systolic Heart Failure: Findings From the American Heart Association Get With The Guidelines-Heart Failure Program. JACC Heart Fail. 2016;4:649-61 pubmed publisher
    ..Unlike patients with normal renal function, there was no significant change in 1-year clinical outcomes over time among HF patients on dialysis. ..
  14. Fonarow G, Albert N, Curtis A, Stough W, Gheorghiade M, Heywood J, et al. Improving evidence-based care for heart failure in outpatient cardiology practices: primary results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Circulation. 2010;122:585-96 pubmed publisher
    ..URL: Unique identifier: NCT00303979. ..
  15. request reprint
    Fonarow G. Improving quality of care and outcomes for heart failure. -Role of registries-. Circ J. 2011;75:1783-90 pubmed
  16. Patel D, Shah R, Bhatt D, Liang L, Schulte P, DeVore A, et al. Guideline-Appropriate Care and In-Hospital Outcomes in Patients With Heart Failure in Teaching and Nonteaching Hospitals: Findings From Get With The Guidelines-Heart Failure. Circ Cardiovasc Qual Outcomes. 2016;9:757-766 pubmed publisher
    ..07). Data from the GWTG-HF program suggest that there was improving and comparable adherence with HF performance measures and use of guideline-recommended therapies irrespective of hospital teaching status. ..
  17. Fonarow G, Smith E, Saver J, Reeves M, Bhatt D, Grau Sepulveda M, et al. Timeliness of tissue-type plasminogen activator therapy in acute ischemic stroke: patient characteristics, hospital factors, and outcomes associated with door-to-needle times within 60 minutes. Circulation. 2011;123:750-8 pubmed publisher
    ..5 years. These findings support the need for a targeted initiative to improve the timeliness of reperfusion in acute ischemic stroke. ..
  18. Pandey A, Kim S, Moore C, Thomas L, Gersh B, Allen L, et al. Predictors and Prognostic Implications of Incident Heart Failure in Patients With Prevalent Atrial Fibrillation. JACC Heart Fail. 2017;5:44-52 pubmed publisher
    ..Traditional HF risk factors, AF type, and baseline heart rate are independent clinical predictors of incident HF. ..
  19. Khera R, Pandey A, Kumar N, Singh R, Bano S, Golwala H, et al. Variation in Hospital Use and Outcomes Associated With Pulmonary Artery Catheterization in Heart Failure in the United States. Circ Heart Fail. 2016;9: pubmed
    ..This is accompanied by a decline in excess mortality associated with PA catheterization. ..
  20. Ziaeian B, Kominski G, Ong M, Mays V, Brook R, Fonarow G. National Differences in Trends for Heart Failure Hospitalizations by Sex and Race/Ethnicity. Circ Cardiovasc Qual Outcomes. 2017;10: pubmed publisher
    ..An evaluation of factors explaining the improvements in the HF hospitalization rates among Hispanics and Asian/Pacific Islanders is needed. ..
  21. Pandey A, Golwala H, Xu H, DeVore A, Matsouaka R, Pencina M, et al. Association of 30-Day Readmission Metric for Heart Failure Under the Hospital Readmissions Reduction Program With Quality of Care and Outcomes. JACC Heart Fail. 2016;4:935-946 pubmed publisher
    ..These findings raise questions about the validity of the HRRP performance metric in identifying and penalizing low-performance centers. ..
  22. Lyons K, Ezekowitz J, Liang L, Heidenreich P, Yancy C, DeVore A, et al. Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy. JACC Heart Fail. 2017;5:388-392 pubmed publisher
    ..In this population of patients with HF, an LVEF ≤35%, and no documented contraindication for CRT, the current ACCF/AHA HF guidelines reduce the proportion of patients eligible for CRT by approximately 15%. ..
  23. Pokorney S, Kim S, Thomas L, Fonarow G, Kowey P, Gersh B, et al. Cardioversion and subsequent quality of life and natural history of atrial fibrillation. Am Heart J. 2017;185:59-66 pubmed publisher
    ..Many patients who undergo cardioversion do not receive adjunctive rhythm control therapies. These findings may help to better inform therapeutic decision making. ..
  24. Xian Y, Xu H, Lytle B, Blevins J, Peterson E, Hernandez A, et al. Use of Strategies to Improve Door-to-Needle Times With Tissue-Type Plasminogen Activator in Acute Ischemic Stroke in Clinical Practice: Findings from Target: Stroke. Circ Cardiovasc Qual Outcomes. 2017;10: pubmed publisher
    ..Nevertheless, certain strategies were infrequently practiced and represent a potential immediate target for further improvements. ..
  25. Ziaeian B, Heidenreich P, Xu H, DeVore A, Matsouaka R, Hernandez A, et al. Race/Ethnic Differences in Outcomes Among Hospitalized Medicare Patients With Heart Failure and Preserved Ejection Fraction. JACC Heart Fail. 2017;5:483-493 pubmed publisher
    ..These differences in mortality and readmission risk according to race/ethnicity persisted after adjusting for patient characteristics, SES, and hospital factors. ..
  26. DeVore A, Thomas L, Albert N, Butler J, Hernandez A, Patterson J, et al. Change the management of patients with heart failure: Rationale and design of the CHAMP-HF registry. Am Heart J. 2017;189:177-183 pubmed publisher
  27. Steinberg B, Shrader P, Thomas L, Ansell J, Fonarow G, Gersh B, et al. Factors associated with non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II). Am Heart J. 2017;189:40-47 pubmed publisher
    ..Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Identifier: NCT01701817. ..
  28. Sutton N, Li S, Thomas L, Wang T, de Lemos J, Enriquez J, et al. The association of left ventricular ejection fraction with clinical outcomes after myocardial infarction: Findings from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry-Get With the Guidelines (GWTG) Medicare-linked da. Am Heart J. 2016;178:65-73 pubmed publisher
    ..11, 95% CI 1.09-1.12). Low EF after MI remains an important risk factor for postdischarge mortality and hospital readmission, even after adjustment for patient and hospital characteristics. ..
  29. Patel N, Ju C, Macon C, Thadani U, Schulte P, Hernandez A, et al. Temporal Trends of Digoxin Use in Patients Hospitalized With Heart Failure: Analysis From the American Heart Association Get With The Guidelines-Heart Failure Registry. JACC Heart Fail. 2016;4:348-56 pubmed publisher
    ..0001). One in 5 HFrEF patients received digoxin at discharge, with a significant downward temporal trend in use over the study period. Use of digoxin in HFpEF patients without AF was very low and decreased over the study period. ..
  30. Fonarow G, Yancy C, Hernandez A, Peterson E, Spertus J, Heidenreich P. Potential impact of optimal implementation of evidence-based heart failure therapies on mortality. Am Heart J. 2011;161:1024-30.e3 pubmed publisher
    ..These data may underscore the importance of performance improvement efforts to translate evidence-based therapy to routine clinical practice so as to reduce contemporary HF mortality. ..
  31. Man S, Cox M, Patel P, Smith E, Reeves M, Saver J, et al. Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization. Stroke. 2017;48:412-419 pubmed publisher
    ..These findings may have important implications for further improving systems of care. ..
  32. Fonarow G, Liang L, Thomas L, Xian Y, Saver J, Smith E, et al. Assessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries. Stroke. 2016;47:836-42 pubmed publisher
    ..Home-time represents a novel, easily measured, patient-centered, outcome measure for an episode of stroke care. ..
  33. Echouffo Tcheugui J, Shrader P, Thomas L, Gersh B, Kowey P, Mahaffey K, et al. Care Patterns and Outcomes in Atrial Fibrillation Patients With and Without Diabetes: ORBIT-AF Registry. J Am Coll Cardiol. 2017;70:1325-1335 pubmed publisher
    ..Among AF patients, diabetes was associated with worse AF symptoms and lower quality of life, and increased risk of death and hospitalizations, but not thromboembolic or bleeding events. ..
  34. Hsu J, Ziaeian B, Fonarow G. Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions. JACC Heart Fail. 2017;5:763-771 pubmed publisher
  35. Shah K, Xu H, Matsouaka R, Bhatt D, Heidenreich P, Hernandez A, et al. Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. J Am Coll Cardiol. 2017;70:2476-2486 pubmed publisher
    ..These findings underscore the need to improve treatment of patients with HF. ..
  36. Kim S, Molnar M, Fonarow G, Streja E, Wang J, Gillen D, et al. Mean platelet volume and mortality risk in a national incident hemodialysis cohort. Int J Cardiol. 2016;220:862-70 pubmed publisher
    ..Hemodialysis patients with higher MPV have heightened mortality risk. Further studies are needed to determine the pathophysiologic basis for the higher risk, and if modification of MPV ameliorates mortality in this population. ..