Ralph J. Riello III, PharmD, BCPS
Assistant Professor Adjunct (Nephrology)Cards
About
Research
Publications
Featured Publications
Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageElectronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial
Ghazi L, Yamamoto Y, Riello RJ, Coronel-Moreno C, Martin M, O'Connor KD, Simonov M, Huang J, Olufade T, McDermott J, Dhar R, Inzucchi SE, Velazquez EJ, Wilson FP, Desai NR, Ahmad T. Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial. Journal Of The American College Of Cardiology 2022, 79: 2203-2213. PMID: 35385798, DOI: 10.1016/j.jacc.2022.03.338.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyUsual careEjection fractionHeart failureMedical therapyPrimary outcomeCluster-randomized comparative effectiveness trialSodium-glucose cotransporter 2 inhibitorsElectronic health record alertsAldosterone system inhibitorsReduced ejection fractionUsual care armCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsVentricular ejection fractionComparative effectiveness trialNumber of patientsKnowledge of guidelinesLow-cost interventionCare armDays postrandomizationEligible patientsGDMT useFailure therapyPatient characteristicsARNI and MRA Combination in PARAGON-HF: Odd Couple or Dynamic Duo?
Riello RJ, Pitt B. ARNI and MRA Combination in PARAGON-HF: Odd Couple or Dynamic Duo? JACC. Heart Failure 2021, 9: 25-27. PMID: 33309576, DOI: 10.1016/j.jchf.2020.10.005.Commentaries, Editorials and LettersEmpagliflozin in Heart Failure
Griffin M, Rao VS, Ivey-Miranda J, Fleming J, Mahoney D, Maulion C, Suda N, Siwakoti K, Ahmad T, Jacoby D, Riello R, Bellumkonda L, Cox Z, Collins S, Jeon S, Turner JM, Wilson FP, Butler J, Inzucchi SE, Testani JM. Empagliflozin in Heart Failure. Circulation 2020, 142: 1028-1039. PMID: 32410463, PMCID: PMC7521417, DOI: 10.1161/circulationaha.120.045691.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsCotransporter 2 inhibitorsNeurohormonal activationHeart failureRenal dysfunctionBlood volumeHeart failure-related outcomesPlacebo-controlled crossover studyType 2 diabetes mellitusProximal tubular siteHeart failure outcomesStable heart failureUrinary glucose excretionUric acid levelsElectrolyte wastingEmpagliflozin monotherapyOral empagliflozinPlacebo periodStudy drugGlucose excretionNatriuretic effectPotassium wastingTubular sitesDiabetes mellitusFractional excretionSodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series
Griffin M, Riello R, Rao VS, Ivey-Miranda J, Fleming J, Maulion C, McCallum W, Sarnak M, Collins S, Inzucchi SE, Testani JM. Sodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series. ESC Heart Failure 2020, 7: 1966-1971. PMID: 32476296, PMCID: PMC7373933, DOI: 10.1002/ehf2.12759.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureSodium-glucose cotransporter 2 inhibitorsGlucose cotransporter 2 inhibitorsDecompensated heart failureCotransporter 2 inhibitorsType 2 diabetesSGLT-2iBlood pressureHeart failureUrine outputYale-New Haven HospitalWeight lossIncidence of hypokalaemiaSGLT-2i initiationSGLT-2i therapyGlucose-lowering medicationsHeart failure outcomesCohort of patientsAverage weight lossDiuretic dosingDiuretic resistanceAdjunctive therapyWorsened survivalDiuretic efficiencyDiuretic monotherapyEffect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure
Clarke JD, Riello R, Allen LA, Psotka MA, Teerlink JR, Lindenfeld J, Desai NR, Ahmad T. Effect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure. Circulation Heart Failure 2021, 14: e007759. PMID: 33530705, DOI: 10.1161/circheartfailure.120.007759.Peer-Reviewed Original ResearchConceptsEnd-stage heart failureReduced ejection fractionHealth-related qualityPatient-reported health statusEffect of inotropesHeart failureHealth status domainsEjection fractionHealth statusFunctional statusPositive inotropesStatus domainsAvailable clinical trial dataMorbidity/mortalityPopulation of patientsPatient-centered outcomesHealth status outcomesClinical trial dataFunctional capacity changesQuantity of lifeWeb of ScienceInotrope therapyInotrope useCalcium sensitizerSurvival benefitNatriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure
Rao VS, Ivey-Miranda JB, Cox ZL, Riello R, Griffin M, Fleming J, Soucier R, Sangkachand P, O'Brien M, LoRusso F, D'Ambrosi J, Churchwell K, Mahoney D, Bellumkonda L, Asher JL, Maulion C, Turner JM, Wilson FP, Collins SP, Testani JM. Natriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure. Journal Of The American College Of Cardiology 2021, 77: 695-708. PMID: 33573739, PMCID: PMC8114781, DOI: 10.1016/j.jacc.2020.12.022.Peer-Reviewed Original ResearchConceptsLoop diuretic administrationDiuretic therapyNatriuretic responseDiuretic administrationSodium outputAcute decompensated heart failureDecompensated heart failureHeart failure admissionsDaily urine outputSpot urine samplesNet fluid outputNet fluid lossPathway cohortHeart failureLoop diureticsUrine outputDiuretic responseResidual congestionFluid outputTherapyCohortWeight lossAdditional studiesUrine samplesExcellent discriminationRationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Clark K, Victoria-Castro A, Ghazi L, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use. JACC Heart Failure 2023, 12: 322-332. PMID: 37943221, DOI: 10.1016/j.jchf.2023.08.025.Peer-Reviewed Original ResearchBest practice alertMineralocorticoid receptor antagonistsNovel potassium bindersPotassium bindersEligible patientsUsual careEjection fractionSerum potassiumHistory of hyperkalemiaIncidence of hyperkalemiaStrong guideline recommendationsHeart failure hospitalizationReduced ejection fractionLaboratory test valuesPopulation health outcomesHyperkalemia treatmentMRA prescriptionAntagonist useFailure hospitalizationPatient characteristicsSecondary outcomesHeart failurePrimary outcomeGuideline recommendationsOutpatient visitsContemporary American and European Guidelines for Heart Failure Management: JACC: Heart Failure Guideline Comparison.
Ostrominski JW, DeFilippis EM, Bansal K, Riello RJ 3rd, Bozkurt B, Heidenreich PA, Vaduganathan M. Contemporary American and European Guidelines for Heart Failure Management: JACC: Heart Failure Guideline Comparison. JACC Heart Fail 2024 PMID: 38583167, DOI: 10.1016/j.jchf.2024.02.020.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSequencing Quadruple Therapy for Heart Failure with Reduced Ejection Fraction: Does It Really Matter?
Hu J, Schwann A, Tan J, Nuqali A, Riello R, Beasley M. Sequencing Quadruple Therapy for Heart Failure with Reduced Ejection Fraction: Does It Really Matter? Cardiology Clinics 2023, 41: 511-524. PMID: 37743074, DOI: 10.1016/j.ccl.2023.06.007.Peer-Reviewed Original ResearchConceptsReduced ejection fractionEjection fractionHeart failureChronic kidney diseaseQuadruple therapyTarget dosingTherapy initiationAtrial fibrillationKidney diseaseSpecial populationsMedicationsConventional sequencesTolerabilityBradycardiaPatientsFailureFibrillationDosingTherapyInitiationDiseaseDosesGDMT
Academic Achievements and Community Involvement
Links & Media
Media
News
- November 15, 2023
Welcome New Staff, Faculty, Postdoctoral Associates/Fellows & Postgraduate Associates/Fellows (Nov. 2023)
- November 21, 2022
Most-read Content of November: Analysis of patient-focused web pages about LAAO, PROMPT-LIPID, and antiplatelet regimens
- November 06, 2022
PROMPT-Lipid: Electronic Alerts Improve Long-term Uptake of Lipid Lowering Medication
- November 02, 2022Source: Becker's Hospital Review
How targeted EHR alerts can close practice gaps and improve patient care: insights from an expert at Yale School of Medicine