Madiha Khan

Taking out the guess work in establishing CVD risk with CAC! 👉2/3 adults without ASCVD are candidates for statin 👉1 in 2 statin candidates have CAC of 0 #CNC2021 #cardioprevention #cardiotwitter

@DFCapodanno @NEJM Tough week in a long line of tough years

Perfect timing—and a bit of a cruel twist, one might say. In a week, CHAMPION-AF may tell a different story, but the long-awaited CLOSURE-AF, now out in @NEJM, makes for a tough week ahead for those supporting left atrial appendage closure. nejm.org/doi/full/10.10…

One of the most meaningful evolutions in the 2026 ACC/AHA dyslipidemia guideline is the continued elevation of CAC as a central tool in preventive decision-making. We have come a long way. 1. In the 2013 guidelines, CAC was effectively sidelined. 2. By 2019, it re-emerged as a decision aid. 3. In 2026, it is now clearly embedded in the framework of risk assessment, treatment initiation, and treatment intensity. Two messages stand out. 1. First, CAC has become the preferred decision aid when treatment decisions are uncertain. This is not an uncommon situation. In real-world practice, uncertainty is the rule rather than the exception, especially in borderline or intermediate-risk individuals. #PowerOfZero provides a clear distinction who is and not at risk that for the decision whether lipid-lowering therapy should be initiated. 2. Second, the guideline goes beyond initiation. CAC is increasingly used to guide the intensity of therapy. Increasing plaque burden corresponds to progressively more aggressive LDL targets and therapeutic strategies. For example, individuals with CAC ≥300–1000 are recommended to pursue LDL reduction strategies approaching secondary prevention intensity, reflecting event rates comparable to treated ASCVD populations. This is a MAJOR shift. CAC is no longer simply a tie-breaker for statin decisions. It is evolving into a disease-guided framework for preventive intensity. From a practical standpoint, this matters.Risk equations estimate probability. CAC visualizes disease. 1. When uncertainty exists, seeing the burden of atherosclerosis often changes the conversation for both clinician and patient. 2. It also aligns therapy more closely with biology (GREATER DISEASE, MORE INTENSE THE TREATMENT) rather than risk-factor projections alone. IN 2026. CAC has moved from the margins of guidelines to the center of preventive cardiology. For clinicians, that represents one of the most practical advances in translating risk assessment into actionable care. Congrats @rblument1 @RonBlankstein @DrMichaelShapir & rest of the guideline authors @AJPCardio @ASPCardio @MichaelJBlaha @Sadeer_AlKindi @HMethodistCV

@mderdem3 @HMethodistCV @DeBakeyCVedu 🔥🔥🔥🔥

Excited to present our UNICORN assisted ViV TAVR technique tomorrow at #CRT2026! To learn more about this leaflet modification technique to prevent coronary obstruction during ViV procedures, please join us on Sunday at 9:18 AM Theater #1. 🫀

Where are cholesterol guidelines headed, and what must the clinical and prevention community do to keep up? This excellent review just published @AJPCardio by @AlexRazavi @seamuswhelton @JSpitz_MD @rblument1 and colleagues maps out key updates across international cholesterol guidelines, while forecasting the next set of shifts that will shape lipid management globally. #fig0002" target="_blank" rel="nofollow noopener">sciencedirect.com/science/articl… The five domains outlined 1. Risk Assessment The shift to the PREVENT model, with more contemporary calibration and lower estimated risk for the same clinical profiles, will likely support earlier intervention in broader populations. However, an open question remains: Is this model meaningfully better than the PCE in influencing decision-making at the individual level? 2. Subclinical Atherosclerosis Imaging CAC scoring is no longer optional. Beyond its well-known role in reclassification, newer data show its potential to enhance adherence, risk communication, and treatment intensification. It should be more routinely incorporated, particularly in intermediate-risk individuals and as a tool to guide escalation in higher-risk groups. 3. Combination Lipid-Lowering Therapy The traditional escalation model is increasingly misaligned with modern prevention goals. Trials like RACING and CLEAR Outcomes reinforce the value of early combination therapy, not only to reach LDL-C targets, but also to address clinical inertia and optimize adherence. Inclisiran may offer additional value, especially where adherence or access remains a barrier. 4. LDL-C Targets Among patients with established ASCVD or high atherosclerotic burden, the safety and efficacy of achieving very low LDL-C levels  is now supported by long-term trial data. Despite this, many patients remain above guideline-recommended thresholds. Narrowing this gap will require a shift in routine practice toward multi-agent therapy and tighter treatment monitoring. 5. Lipoprotein(a) Universal Lp(a) testing is increasingly endorsed by major societies. Until dedicated therapies are available, prioritizing individuals with elevated Lp(a) for more intensive LDL-C lowering may represent a practical near-term strategy, especially in younger patients with family history or unexplained residual risk. Whether direct Lp(a) lowering leads to substantial outcome benefits remains to be determined. This review offers a clear, structured lens into how the science and policy around lipid management are evolving. The next phase will depend not only on updating guidelines, but on translating them into practical, scalable strategies. @ASPCardio @alirahimi06 @JamalRanaMD @MethodistHosp @DeBakeyCVedu @CiccaroneCenter @DrMichaelShapir @nationallipid

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@ASPCardio @khurramn1 @AJPCardio @ErinMichos @DrNathanWong Many congrats Dr. Nasir!!!

Welcome to @khurramn1, who is now serving as Editor-in-Chief of @AJPCardio! Thank you to @ErinMichos & @DrNathanWong for their outstanding leadership. Make sure to read the latest issue🫀sciencedirect.com/journal/americ…  #PreventiveCardiology #ASPC #AJPC

A lovely evening a home with our graduating fellows later this yr: laughs, dinner conversations, reminiscing & aspiring for a great future. What a group! Congratulations🎉 ⁦@HMethodistCV⁩ ⁦⁩ ⁦@ACCinTouch⁩ ⁦@ASE360⁩ ⁦@SCMR⁩ ⁦@DrMarthaGulati

A pivotal moment Strongly believe #DigitalHealth & #AI has the #TransformativePower to redefine healthcare & spark a ripple effect of progress for years to come Truly a remarkable opportunity for us to showcase what can be achieved when medicine & technology unite! #DreamBig

🚨 Exciting news! Houston Methodist and Rice University launch the Digital Health Institute to advance patient care through AI and innovation. Kudos to our Preventive Fellowship Program Director, Dr. @khurramn1 for leading this effort! Learn more: houstonmethodist.org/newsroom/houst…

@Doctors__squad Saw this in my college stats class and I have yet to come across a better memeplanation of a concept.

At Grand Rounds today Cardiology fellows Syed Ali, MD and Madiha Kahn, MD spoke on "The History of Percutaneous Coronary Intervention" and "Age Ain't Nothing But a Non-Zer Number." Join us LIVE and In-person every Thurs, 8-9am. @AlanLumsdenMD @HMethodistCV youtube.com/live/vuMamy52m…

Always very proud of our fellows as they step up to present the pearls and science of Cardiology. Ready for the next chapter. Houston, we have launch 🚀

Marking DeBakey grand rounds off the fellowship bucket list ✅ 🥹🎉

We're partnering with @RiceUniversity to launch Houston Methodist-Rice Digital Health Institute, focused on transforming patient care & population health through digital innovation Seeking an Executive Director to lead this groundbreaking initiative! emdz.fa.us2.oraclecloud.com/hcmUI/Candidat…

cardiac prevention 🤝 punny titles Excited to chat about this 🔥 topic! Livestream link ~and more puns~ to follow🔗🔗 #MedEd

🩺💙 The HMH Cardiology team is advancing heart care and making a real impact. #HMHCardiology #HeartHealth #Teamwork

@SLittleMD @ci_angulo Happy 30th birthday, Dr. Little! May your E/e’ remain forever low.

@ci_angulo Thank you dear Clara. Still waiting for the new wisdom to kick in.

@SLittleMD Happiest Birthday 🎂🎊🎉🍷

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@MarwanSaadMD @AhmedElkaryoni @MohammedQintar @kalazizimd @mirvatalasnag @AlkashkariWail @PinakShahMD @mnyoung1 @DeVriesJt @EmadHakemiMD @aicardio @djc795 @CathElectroSurg Stroke volume working overtime…

New level of challenge unlocked. VTI ratio 0.11. Emergent Sunday TAVR. What is the highest gradients you’ve seen? @AhmedElkaryoni @MohammedQintar @kalazizimd @mirvatalasnag @AlkashkariWail @PinakShahMD @mnyoung1 @DeVriesJt @EmadHakemiMD @aicardio @djc795 @CathElectroSurg

@BrownJHM @CBlumenthal2 @CardioNerds Timeless✨ @a_h_ghoneem 💯

Right heart catheterization @a_h_ghoneem @CBlumenthal2 @cardionerds #cardiology #medEd