About Us

Rolando L. deGoma, MD. FACC, FNLA is a dedicated non-invasive cardiologist, preventive cardiologist and clinical lipidologist (cholesterol specialist) with over 30 years of private practice experience. He is board certified in Internal Medicine, Cardiology and Clinical Lipidology.  He is a Fellow of the American College of Cardiology and the National Lipid Association. 

The cover page of a recent issue of the American College of Cardiology showed a mortality line graph with an arrow pointing up - it reads death from heart disease on the rise. 

DeathFromHeartDiseaseOnTheRise2

The federal statistics showed that after more than two decades of decline, mortality trends from cardiovascular disease have risen since 2011. This is an alarming trend. The total annual economic burden of CVD is estimated at $500 billion now and projected to increase to $1 trillion by 2035.

I have been fortunate to have a long career in cardiology - I have witnessed and have participated in the evolution of our approach to the management of CHD and I believe that what is inevitably coming is more revolutionary than just plain evolutionary.

I was practicing traditional noninvasive cardiology for the first 20 years until 2001. I was treating heart disease, not fighting heart disease. In those first 20 years, many CHD patients were almost routinely treated with interventions - CABG, angioplasty and stent. Regardless of which treatment the patients received, without aggressive prevention, many of these patients were caught in a revolving door of recurring events which as I mature as a practicing cardiologist became frustrating. Many times I was called to the ER to attend to patients having a major heart attack and died within 24 hours. Now, we manage STEMI with rapid stenting. We assumed the shorter door-to-ballon time will save more lives but it didn’t. This approach is time-sensitive and requires intensive effort by a group of dedicated people hoping to save more lives. The shorter the door to ballon time, the more patients will be saved. But it didn't not. This approach is just treating heart attack is not fighting heart disease because  it waited for a plaque to rupture and cause a heart attack, then it triggers a valiant effort to save more lives but It does not. What is sure to save lives is identifying those who are likely to have an event within the next ten years and then stopping atherosclerosis progression by treating them with optimal lipid-centered medical therapy. This approach saves lives in both primary and secondary prevention settings.

So in 2001, I had a professional conversion experience in my approach to the management of CV disease - I decided to find a way to incorporate aggressive prevention as a component of all routine cardiology visits. I became a clinical lipidologist and developed/invented my own clinical management system. In 2001, the L-TAP study, a nationwide survey, showed that only 18% of CHD patients were treated to an LDLc less than 100 mg/dL. We published our first performance data in 2006 with 85% at LDL goal <100 and 33% below 70. By then, cardiovascular events were starting to decline and this decline continues up to the present. What used to be common and expected cardiovascular events (heart attack, stroke, angina, sudden cardiac death, cardiac interventions) became uncommon and unexpected. Last May, we published our second performance data with 89% at goal <100, 50% less than 70. In both publications, over 90% were on statin. The STENO-2 trial, a European study, showed that statin therapy accounts for about 70% of the event reductions, BP control 20%, diabetic control 20%. 

Ideally, as many as possible of our high risk patients should be prescribed a statin and they stay on statin indefinitely. But the reality is a bit different. Long term success in lipid management is determined by tolerability, real or perceived side effects, cost, your explanation to patients and their understanding of the benefits of statin therapy and what they read in the internet and hear from their friends. I put together a 3 minute PowerPoint video of what we do to fight heart disease in our community since 2001.

ACC President 2004

ACC President 2004

In 2004, Dr. Wolk, the president of his professional organization - the American College of Cardiology (ACC) posed this question - “So, why aren’t all cardiologist preventive?”.  We all knew exactly why.

ACC President 2015

ACC President 2015

11 years later, Dr. Williams, the 2015 ACC president addressed the same question and proposed that - “It is time to turn off the faucet instead of just mopping the floor.”

In Dr. deGoma’s practice, turning off the faucet started in 2001 and five years later, the mopping of the floor stopped.

Download my resume here.

Download NLA feature article: My Journey to Prevention.

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