Our review now published
@NatureMedicine
. We brought together an interdisciplinary team of physicians on the front lines of COVID-19 to provide a concise review of how COVID-19 can affect several organ systems besides the lungs.
Yesterday a fellow…. Today an attending… Feels surreal to get here after 17 years of medical training! Feel very blessed to have this opportunity to be on faculty
@CedarsSinaiMed
! Excited for new beginnings :)
Excited to have had the opportunity to contribute to the
@NEJM
Clinical Update on Transcatheter Management of Mitral Regurgitation with
@RajMakkar4
- we highlight findings from completed and ongoing trials of TEER and TMVR.
@CedarsSinaiMed
@CedarsSinai
1/ A silver lining in all of this is that working in a resource-strained setting makes us clinically stronger. Here are some changes that occurred very quickly as we started to get crushed with COVID CCU admissions:
Thanks to
@ACCintouch
#ACCFIT
for giving me an opportunity to share my experiences in the new world of COVID -
My COVID-19 Experience: Aakriti Gupta, MD, MS - American College of Cardiology
And its a wrap! What an incredible honor to have trained with these amazing, kind, brilliant and super fun cofellows
@ColumbiaCardio
! Learning interventional cardiology together was a rollercoaster ride full of silly banter, some tears and a lot more laughter! Will miss you all:)
There is a lot of talk of ventilators. But we are not talking enough about CVVH machines. Given the overwhelming renal failure in ICU patients with COVID, these dialysis machines are becoming harder to find.
Thanks to
@mw_sherwood
for the opportunity to co-lead this study
@CircIntv
using the STS-TVT registry with CMS linkage showing widespread variability in antiplatelet/anticoagulation regimen in patients with atrial fibrillation undergoing TAVR.
@djc795
@ericpetersonMD
@ajaykirtane
What an honor to have shared my training journey with this legend! Look forward to many more shared pursuits!
@hmkyale
would have completed this picture!
In this report from Medicare in
@amjmed
, we report that aortic valve replacement rates within 6 months of hospitalization for aortic stenosis are much lower for racial/ethnic minorities in the US, even for urgent/emergent admissions.
@hmkyale
@mori_md
@SmidtHeart
@CedarsSinaiMed
What an absolute privilege and honor it has been to learn from
@RajMakkarMD
every day and watch him leave an indelible impact on the field! So well deserved!
It's with great pride we share that
@SmidtHeart
Raj Makkar, MD has been awarded this year's prestigious
@CedarsSinai
Pioneer in Medicine Award! He has reshaped the landscape of interventional cardiology worldwide. Congrats Raj!
@CedarsSinaiMed
#CardioTwitter
“I have never seen an infectious disease that can cause quite so many kinds of clinical presentations, so many kinds of disease as coronavirus.” -- Dr.
@celinegounder
"The diversity of presentation is really scary for all of us." -- Dr.
@methodsmanmd
So proud to be mentored by one of the most humble, passionate and inspirational individuals I know whose relentless passion for scientific investigation has touched the lives of many.
#AHA2019
#PresidentialAwards
@hmkyale
The look when pizza is delivered by
@ColumbiaMed
program director, Dr. David Chong, while attending on ICU service with medicine residents! Really grateful for his very thoughtful gesture!
My former mentor Dr. David Chong, medical director of ICUs + IM residency PD at
@nyphospital
Columbia has been raising money to feed health workers.
Y’all know the feeling seeing bagels when you walk into the hospital 🙏
Gofundme link below
#medtwitter
After some exciting live case transmissions from
@CedarsSinai
, now in Chicago to attend
#TVT2022
in person to learn the latest and greatest in structural heart disease!
Thank you
@hmkyale
for your visionary and transformative leadership. It is a great honor to serve alongside this amazing group to advance cardiovascular science and further JACC’s mission to ultimately improve patient outcomes.
We just named
#JACC
Editors: “Our remarkable Editors will apply their wisdom, talent, and kindness to propel our mission, ensuring that the finest articles, honed through rigorous peer review, reach publication and have the greatest impact”
@JACCJournals
Really proud of my friend
@bbikdeli
who continues to outdo himself with every subsequent project/paper. And is an INSPIRATION to us all :) This was a tremendous undertaking that he completed masterfully along with
@psadeghipour
and rest of the team. Congrats!
In this international collaboration
@OHDSI
@JAMA_current
study, we demonstrate using open science that ticagrelor may not be better than clopidogrel, but may be associated with higher bleeding after PCI. Potential for practice change if replicated in further prospective studies.
In
@JAMA_current
, our article comparing ticagrelor and clopidogrel in patients with an acute coronary syndrome undergoing PCI. A remarkable international collaboration. Bottom line: more expensive med not better.
Enormous congratulations to
@hmkyale
! Cant wait to see him bring his unparalleled expertise and passion for research, collaboration and open science to the helm of
@JACCJournals
- I have no doubt that his visionary leadership will ignite a new era of innovation in publishing
We're pleased to announce Dr. Harlan M. Krumholz, a globally esteemed cardiologist and researcher, as the incoming editor-in-chief of
#JACC
!
Join us in celebrating his appointment and learn more about his incredible contributions to the field:
@hmkyale
Grateful to co-lead this report with tremendous leadership from
@mori_md
and
@hmkyale
showing remarkable progress in AS treatments over the last decade - higher AVR utilization, improved outcomes, increasing home discharge, shorter LOS.
Glad to be part of an in-depth analysis of aortic valve replacement in US elderly, led by remarkable
@mori_md
&
@aakriti_15
w/interdisciplinary team of cardiologists & cardiac surgeons. Findings highlight key trends in the TAVR era.
@JACCJournals
@YaleMed
Experiences like these remind me of how privileged I am to be an interventional cardiologist, and to have the honor to truly make an impact in life-threatening situations like STEMI or shock. An excerpt from a writer patient of mine...
@CedarsSinai
@CedarsCards
"I want my patients to know that when they're in my care, I'm going to be their fiercest advocate for the best medical therapy that is available," says Dr. Gupta (
@aakriti_15
).
Cedars-Sinai offers virtual second opinions to help you make confident decisions about your care.
Our findings from China-PEACE HF showing suboptimal adherence to all 4 ACC/AHA measures for inpatient HF management at hospital level in China underscoring opportunities for national quality improvement initiatives.
@JAMANetworkOpen
@hmkyale
@Dr_BowTie65
So fortunate
@YaleCardiology
to have
@rallamee
visiting for Grand Rounds. She is a rock star. Her science is exemplary, her ideas visionary, and impact profound. She is explaining why we need a placebo-control to test a procedure. So persuasive.
@YaleMed
@imperialcollege
So proud of
@shiwani_mahajan
!! Truly hardworking, sincere, kind and a trailblazer! Cant wait to see the great things that lie ahead for her
@YaleIMed
!
Match Day for medical students in the US - and I am so happy for the new adventures ahead for the amazing students
@YaleMed
with whom I have had the privilege to work. Kudos to all! And fortunate to have
@shiwani_mahajan
continuing her training here!
We hope that this review will come in handy for COVID frontline warriors across the globe and help identify priorities for research and development moving forward.
Thanks so much for the opportunity to share our experience at
@CU_Cardiology
@sahilparikhmd
. And there is certainly a lot to learn from our international colleagues.
Using data from VIRGO - an international observational study examining sex differences in AMI in the young- we find that most sleep apnea is undiagnosed at the time of AMI - and young women with AMI and high risk of sleep apnea at baseline have worse functional outcomes.
During today's Summer
#COVID19
Series, Dr. Gupta will discuss the multi-system nature of COVID. Read his review which was published in
@nature
here:
#ACCEd
We were very fortunate to have an amazing team of both junior and senior investigators, who helped review extensive evidence combined with our own insights from caring for these patients to bring this together.
@hmkyale
@GreggWStone
@ajaykirtane
@NirUrielMD
@MathewMaurer
Will present our work from STS/TVT highlighting trends in use of different anti thrombotic regimens in patients with atrial fibrillation undergoing TAVR and their associated outcomes at 1 year. Look forward to seeing you at noon! With
@mw_sherwood
@ajaykirtane
@ericpetersonMD
What is the median time to AVR once patients with severe AS develop symptoms? What are the predictors of delay and does delay in treatment lead to worse outcomes? We answer these questions using natural language on Monday at
#AHA
@chrislbs
@MartyMleon
@hmkyale
Very interesting insights to be gained from this preprint paper from
@ColumbiaMed
@nyphospital
. Most striking to me (a) 29% of critically ill patients required renal replacement therapy (b) 63% of critically ill patients had hypertension (more common than diabetes in 36%)
Thats an interesting observation
@leorahorwitzmd
. While taking care of patients in the ICU setting at
@nyphospital
, we are seeing A LOT of AKI progressing to anuric renal failure within a couple days such that we are having to share dialysis machines between patients.
3rd, this is not your usual sepsis picture. NONE of my patients, even the deaths/ICUs, developed meaningful AKI or liver failure (most had trivial transaminitis). There is no multiorgan failure. Just respiratory failure (I know reported later cardiac; I didn’t see those).
Truly a world class team doing high-quality and high-impact work touching the lives of many! Anyone would be lucky to have this opportunity!
@bbikdeli
and I were among the lucky ones :)
So fortunate to be working with such an incredible team
@YaleMed
@YNHH
CORE. Multidisciplinary, talented, kind, dedicated, collaborative...what we accomplish, we do as a team. And we celebrate together too. Always looking for great people to join us.
🗞️ New preprint 🗞️
Quantifying the associations between
#SARSCoV2
and severe non-respiratory complications.
A retrospective study using millions of electronic health records of both infected an uninfected people across the U.S. throughout 2020.
🧵
@ambarish4786
@NeilKeshvani
Findings similar to our study from China PEACE 5r HF study published earlier this year showing gaps in adherence to evidence-based guidelines for HF treatment in China with tremendous opportunities for improvement.
@hmkyale
@Dr_BowTie65
@hmkyale
Yes - we are seeing many patients who start out with minor symptoms and then have severe respiratory decompensation 5-10 days later. We are seeing floor patients decompensating a week into their admission and getting transferred to the ICUs.
#ILUMIENIV
@
#HOTLINE
#ESC2023
Take home
•OCT resulted in larger MSA than angio with greater stent expansion
•OCT led to fewer major dissections, malapposition, tissue protrusion and untreated focal reference disease
•OCT reduced angiographic complications
1/18
Certainly proud of being a small part of this amazing organization
@nyphospital
. Humbled daily by peers from pediatrics, surgery, dermatology etc who have assumed all kinds of intensive care roles with us with a welcoming smile!
Fascinating talk on high performance medicine by
@EricTopol
at
@NYPCUCVI
@crfheart
! “It is unlikely that physicians with be replaced by AI. But highly likely to be replaced by physicians who do”
This is a very interesting point and likely deserves more attention. While evaluating the balance of 'wet' versus 'dry', the overwhelming ARDS has led to it weighing more towards 'dry' in our decision-making, and could certainly be leading to high need for CVVH. Need to reassess.
getting this wrong.
- Most patients come to ICU after a few days of illness where their temp was 38-40 and they were hyperventilating i.e. severely dehydrated.
- High rates of AKI being caused by over zealous driving with frusemide, leading to unnecessary CVVHF.
- Hypovolaemia
Honored to be a part of this important work leveraging TOPCAT data to develop risk prediction tools in HFpEF using ML.
@SuveenAngraal
did a great job leading this effort!
@hmkyale
@rohan_khera
3/ A lot of them develop oliguric renal failure by day 2 of ICU stay. As such, we have resorted to placing trialysis catheters instead of triple lumen catheters to avoid double exposure. They also seem to have a protein-losing nephropathy regardless pf diabetes.
As a cardiology fellow and a surgery resident are redeployed to address the Covid-19 pandemic, one person close to them is bearing an unacknowledged burden of the crisis: their 3-year-old son. To protect him, his parents decide to send him hundreds of miles away.
#COVID19
We provide a framework to provide interdisciplinary care for patients with post-acute COVID and reinforce the message that care for COVID does not end at the time of discharge.
We look forward to randomized controlled trials investigating role of statins in different populations with COVID-19 including outpatients, stable inpatients and ICU patients including being led by
@bbikdeli
There is a need to routinely incorporate the assessment of functional impairments and frailty not only in clinical practice, but also in myocardial infarction registries and studies in order to facilitate better characterization of these patients and their outcomes.
4/ Strangely, non-diabetic patients are commonly observed to have anion-gap metabolic acidosis- and are testing positive for serum and urine ketones- we have been treating them according to DKA protocol. Unclear what the pathology might be.