Randal Goldberg

68 posts

Randal Goldberg

Randal Goldberg

@RandyGoldbergMD

Heart failure and txp cardiologist at NYU Langone. Associate Director OHT. Director of HF Bellevue. Cardiac Sarcoidosis. Opinions are my own.

New York, NY Katılım Haziran 2022
107 Takip Edilen225 Takipçiler
Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
@AcademicTruther I think there's a big difference between the utility of the impella CP and 5.5. I think the CP has almost no role for heart failure shock but the 5.5 is a very good device for the patients you describe. More stable placement, better flow, less hemolysis.
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Academic Cardiologist
Academic Cardiologist@AcademicTruther·
So what is your treatment strategy for patients with worsening cardiogenic shock who are failing inotropes / IABP, but not in extremis needing ECMO?
Curmudgeon Cardiologist@curmudgeoncard

The use of the Impella cardiac device has nothing to do with patient outcomes. It’s about money. A high revenue device starting at implant due to complications, numerous echos for placement, and numerous consults for complications. Money, money, money.

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Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
@robertshiuzhang @TaniaAhuja Not sure we need another trial with 5k people (that we'll never get) nor to wait for digitoxin to become available, though should happen. Need to know how to monitor Dig and medication interactions. But, mortality reduction was not significant, so not 5th pillar gdmt for me
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Tania Ahuja 👩🏻‍💻🫀
Tania Ahuja 👩🏻‍💻🫀@TaniaAhuja·
are cardiac glycosides back? 🫀🦊🧤 -digiTOXin is NOT digoxin ⤵️ metabolized in liver, partly to digoxin w/ enterohepatic circulation; NO renal elimination; t1/2 of 5-7 days not 24-48 hrs & 95% protein bound, not 25% -only 19% were on SGLT2inh 🤷‍♀️ -no concomitant amiodarone 👏
NEJM@NEJM

Presented at #ESCCongress: In patients with heart failure and reduced ejection fraction who were receiving guideline-directed medical therapy, digitoxin lowered the risk of death or hospitalization for heart failure as compared with placebo. Full DIGIT-HF phase 4 trial results: nej.md/3HQHLfj @escardio

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Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
@robertshiuzhang @TaniaAhuja Thanks Rob, good to know someone was still awake at the end of that lecture. Agree they are different meds but also that the Dig Trial (original) had a more significant and robust reduction in HF hospitalizations. Now we are seeing a cardiac glycoside with contemporary gdmt.
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Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
Excellent work from past HF, current IC fellow, and upcoming co-attending Erin Flattery showing how advanced HF presence at a SNH can identify advanced therapy candidates and lead to excellent outcomes after LVAD and/or transplant in a very disadvantaged population.
Randal Goldberg tweet media
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Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
@fsheikh22 not sure if you're at ACC, have you seen a case like this? Bottom PET is just 6 weeks into therapy! Simultaneous publication in JACC case reports for more details
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Randal Goldberg retweetledi
Bernard Kadosh
Bernard Kadosh@KadoshBernard·
📢Check out this issue of @JHLT wherein the crackerjack team @nyulangone highlights a gap in the current 🫀 allocation system. Anyone who has cared for a young patient with CAV knows this pain. @sharnksidhu @StephanieGolob @RandyGoldbergMD @ReyentovichHFMD @JasonKatzMD
JHLT@TheJHLT

#HeartTx candidates listed for re-transplant due to severe #CAV have higher risk of dying on the waitlist compared to all other patients at the same tier. Status 4 looks like Status 3. Status 3 looks like Status 2. Time to recalibrate? @KadoshBernard 🔗: jhltonline.org/article/S1053-…

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Randal Goldberg
Randal Goldberg@RandyGoldbergMD·
Come Join us! Variety of pathology, equity in advanced therapies, dual organs (H-K, H-Lu, H-Li), clinical research across the spectrum of disease, and a great team to work with!
Jason N. Katz@JasonKatzMD

Graduating from Cardiology this yr & still considering a career in Adv HF + Transplant? NYU has 1 open ACGME spot. Great diversity of pts, pathologies. Lots of shock, tMCS. High volume VAD + Txp. Dedicated faculty who love to mentor. Message or email: Jason.Katz@nyulangone.org

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Keşfet

@brian_wayda @JamilFrancisMD @NehaParvMD @amitalamMD @MarziaLeacche @ReyentovichHFMD @JasonKatzMD @TmacNY1330