Alexander C. Razavi

Emory cardiology fellow and clinician scientist with a special focus in preventive cardiology @EmoryHeart @CiccaroneCenter

[Roger Blumenthal @rblument1]

Classic review by an all-star group of Prevention Intensivists led by @BuffaloBills insider @AlexRazavi @EmoryDeptofMed @CiccaroneCenter @AaronTroyMD @hopkinsheart #🥍🐦🫀🏏🏊🏼‍♀️⛳️⚾️⚽️

[JACC Journals @JACCJournals]

This #JACCAdvances review highlights key updates from the 2024 AHA/ASA stroke prevention guidelines, including diet, GLP-1 RAs, BP targets, lipid-lowering therapy, & more for personalized #stroke prevention: https://t.co/XVnwLogkIO #StrokeAwarenessMonth #cvPrev

[JACC Journals @JACCJournals]

What's the value of CAC Scoring when Lp(a) is elevated? CAC scoring remains powerful, but risk is higher in those with higher Lp(a) levels in this MESA substudy https://t.co/37zkjtXXI9

#JACC #cvLipids @DrNathanWong @khurramn1 @MichaelJBlaha @AlexRazavi @hsbhatia @MattRamsisMD

[Roger Blumenthal @rblument1]

In Defense of the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline https://t.co/P8AWGvexJg led by @DrMichaelShapir @AlexRazavi @RonBlankstein @CiccaroneCenter @hopkinsheart

[Khurram Nasir @khurramn1]

Can Earlier LDL-C Lowering Change the Trajectory of Cardiovascular Disease?

https://t.co/eVDmXuZrsT

A thought-provoking simultaneous publication new @ProfKausikRay published in @AJPCardio presented at @society_eas yesterday revisits one of the central questions in prevention:

Are we intervening too late?

Using data from 17 randomized lipid-lowering trials involving more than 105,000 participants, Karungi and colleagues examined how the relative cardiovascular benefit of LDL-C lowering changes across different baseline risk levels.

The findings are intriguing.
1. Contrary to the traditional assumption that lower-risk individuals derive only modest benefit, the investigators observed that relative risk reduction per 1 mmol/L LDL-C lowering was actually greater in lower-risk primary prevention populations.
2.  In trial populations with annualized event rates around 1% per year, each mmol/L LDL-C reduction was associated with roughly a 36% relative reduction in events, compared with approximately 13% in populations with event rates near 3% per year.

The paper bring to light an important conceptual framework.
1. As atherosclerosis advances, larger LDL-C reductions may be required to achieve the same proportional benefit.
2.  In lower-risk and presumably earlier-stage disease, even modest LDL-C reductions may yield meaningful relative risk reduction.

This shifts the discussion from simply “who is high risk today?” toward a broader life-course perspective:
1. Are we waiting long before intervening?
2. Can modest but earlier LDL-C lowering alter cumulative vascular exposure before disease becomes biologically irreversible?
3. Should early primary prevention become more central to our prevention frameworks?

I think the implications extend beyond statins alone. For the future we need to think around long-duration therapies, , AI-guided risk prediction, imaging-guided prevention, and cumulative LDL exposure increasingly points toward a future where prevention may begin earlier, become more personalized, and focus more on preserving vascular health before advanced disease develops.

@ASPCardio @rblument1

[Khurram Nasir @khurramn1]

An important extension of the accompanying paper is the editorial by @rblument1 and @AlexRazavi , which frames these findings through a simple but powerful analogy borrowed from Arnold Palmer: “Timing is everything in life and in golf.”

https://t.co/Yd6bOEgLRo

For decades, much of our prevention framework has focused on identifying individuals once short-term risk becomes sufficiently high.

What if we can address the cumulative exposure , then when we lower LDL-C may matter just as much as how much we lower it.

Importantly, the authors do not advocate indiscriminate pharmacotherapy.

Instead, they highlight a more personalized strategy integrating PREVENT risk estimation, inflammatory markers, lipoprotein(a), CKM risk factors, and importantly CAC imaging to identify those most likely to benefit from earlier intervention.

In many ways, the editorial captures an important philosophical shift. The future may not simply be about treating advanced disease more aggressively, but preserving vascular health before advanced atherosclerosis develops.

Timing, indeed, may be everything.

@ProfKausikRay @society_eas @ASPCardio

[Roger Blumenthal @rblument1]

LDL-cholesterol lowering: timing is everything - in ⛳️ & Preventing 🫀disease https://t.co/GUNCqdsKOb - led by the JA17 of Prevention @AlexRazavi @AJPCardio @khurramn1

[Roger Blumenthal @rblument1]

Congrats to @DrMichaelShapir on this great honor. Dr. Shapiro has done a marvelous job as President of ASPC and was a key member of the writing group of the practice-changing 2026 ACC/AHA/Multisociety Dyslipidemia Guideline. Congratulations, Michael on the Arthur Agatston award!

[Roger Blumenthal @rblument1]

Excellent talk by ⁦@hsbhatia⁩ - JHU alumnus- on Lp(a) & CV risk assessment- thanks for coming from the left coast back to Maryland!

[Roger Blumenthal @rblument1]

Congratulations to ⁦@WendyPost9⁩ - Chair of the NIH sponsored MESA steering committee - for running a fabulous meeting in Bethesda! What a great legacy the participants & investigators have contributed to. MESA have revolutionized Preventive Cardiology.

[Maciej Banach @maciejbanach]

#ACC2026 - an amazing arena of #science and #networking; Thank you @ACCinTouch‼️ @worldheartfed @AlexRazavi

[Roger Blumenthal @rblument1]

Fun meals at classic restaurants in NOLA

[JACC Journals @JACCJournals]

#JACCAdvances honors Dr. Alexander C. Razavi with the Young Author Achievement Award for his innovative research, "Primary Prevention Aspirin, Lipoprotein(a), and Cardiorenal Outcomes in #CKD" 🎉

📄: https://t.co/bn1odwF71w

#ACC26 #TheFaceOfCardiology #cvLipids @AlexRazavi

[Carlos Vergara MD @CarlosVergaraMD]

One of the highlights of #ACC26 was the opportunity to talk with @rblument1 about the 2026 dyslipidemia guidelines. I will start with sharing the end of the interview where Dr Blumenthal summarizes in a simple framework what we should be doing as preventive cardiologist with the famous ABCs of CVD prevention published in @AJPCardio : https://t.co/VaIPoaSN73

@AJPCardio @ASPCardio @ACCinTouch @khurramn1 @DrMichaelShapir @AlexRazavi @MichaelJBlaha @Kpakanati3

[JACC Journals @JACCJournals]

Congratulations to the #JACCJournals Awardees, recognized for outstanding research across the JACC family of journals 🎉🎉

Explore the winners and their impactful work: https://t.co/ksd0F82DJG… #ACC26

[Alexander C. Razavi @AlexRazavi]

@DrMichaelShapir @rblument1 @CiccaroneCenter @hopkinsheart @TLeucker Thank you so much!

[Roger Blumenthal @rblument1]

Congratulations to ⁦@AlexRazavi⁩ & Mariam Meddeb on receiving the JACC Caitlin Clark Young Author Achievement & Young Investigator Awards! ⁦@CiccaroneCenter⁩ ⁦@hopkinsheart⁩ ⁦@TLeucker⁩

[Harpreet Bhatia @hsbhatia]

The one and only @AlexRazavi presenting on use of aspirin and CAVD risk in individuals with high OxPL-apoB #ACC26

[Hopkins Med News @HopkinsMedNews]

It’s never too early or too late to help people take steps to support their #CardiovascularHealth. The 2026 ABCs of CVD Prevention was created to help clinicians simplify this process: https://t.co/mTuxjXe2PL @HopkinsHeart @AJPCardio @Ciccarone Center #PreventiveCardiology

[Khurram Nasir @khurramn1]

from the master team @LeaGoren @AaronTroyMD @AllisonWPeng @AlexRazavi @MichaelJBlaha and leader @rblument1 on the updates on ABC's of #CVPrevention

A handout for every one interested, especially the trainees

https://t.co/rVZuztBHLd

@AJPCardio @ASPCardio