**Dear Valued Patient,** I believe that the best medicine is *prevention*—catching trouble before it catches you. Below are the two immunizations I currently **strongly recommend for almost every adult**, together with the cutting-edge screening tests we now perform right here in the office to keep you one step ahead of illness. --- ### 1) The two vaccines that save lives | Vaccine | Who should receive it? | Why now? | | --------------------------------------- | -------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------- | | **Pneumonia (PCV20 or PCV15 → PPSV23)** | All adults **65 +** & anyone 19-64 with heart, lung, diabetes, immune or smoking risks | A single dose of **PCV20** protects against 20 serotypes that cause >90 % of invasive disease. One shot and you’re done. ([cdc.gov][1]) | | **Shingles (Shingrix, 2 doses)** | Everyone **50 +** (or 19 + with a weakened immune system) | Shingrix cuts the risk of shingles by >90 % and slashes the chance of the painful nerve complication (post-herpetic neuralgia). ([cdc.gov][2]) | *We’ll happily check your chart and give either vaccine during your next visit or at our nurse clinic any weekday.* --- ### 2) The preventive tests we offer (and why they matter) | Test | What it does | Who benefits most? | How often? | | ----------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------- | | **AI-Enhanced Coronary CT (Cleerly)** | Creates a 3-D map of every coronary artery, measuring *all* plaque—not just calcium—so we can treat vulnerable artery segments before they rupture. | Anyone with family history, diabetes, high cholesterol, or intermediate 10-year ASCVD risk. | Every 3–5 yrs (or after major lifestyle/therapy changes). ([cleerlyhealth.com][3]) | | **Coronary Artery Calcium (CAC) Score** | A five-minute CT that acts like a “cardiac crystal ball,” re-classifying risk and guiding statin / aspirin decisions. | Adults 40-75 with borderline or intermediate risk, especially if you’re debating medication. | Once; repeat in 5 yrs if risk factors change. ([acc.org][4]) | | **Advanced Lipid & Genetic Panel**
(ApoB, Lp(a), particle size, FH genes) | Finds inherited or “hidden” cholesterol that standard panels miss; elevated **Lp(a)** triples heart-attack risk. | Anyone with personal / family history of early heart disease or stubborn LDL levels. | Once for genetics; annually for advanced lipids. ([heart.org][5]) | | **Carotid Intima-Media Thickness (CIMT) & Arterial Stiffness Ultrasound** | Detects microscopic artery thickening years before a blockage shows up. | Ages 35 + with risk factors, competitive athletes, or anyone seeking an “arterial age.” | Every 3 yrs (or sooner when risk factors worsen). | | **AI-Guided ECG & Ambulatory Rhythm Monitoring** | FDA-cleared algorithms catch silent atrial fibrillation and early conduction issues in a single-lead or 12-lead trace. | Anyone 50 +, athletes with palpitations, patients with sleep apnea, hypertension, thyroid issues. | Baseline once; repeat if symptoms develop. ([fda.gov][6]) | | **Galleri® Multi-Cancer Early Detection Blood Test** | Screens for a DNA “cancer signal” from 50+ tumors (pancreatic, ovarian, liver, etc.) with a single blood draw. | Adults **50 +** or anyone with elevated cancer risk/family history. | Yearly. ([grail.com][7]) | | **Metabolic & Inflammation Panel**
(hs-CRP, fasting insulin, HOMA-IR, uric acid) | Uncovers hidden insulin resistance and low-grade inflammation—the sparks that ignite heart disease, dementia, and cancer. | All adults every 1-2 yrs; sooner if overweight, sedentary, or family history of diabetes. | Annually or with lifestyle changes. | | **DEXA Body-Composition & Bone Density Scan** | Simultaneously measures visceral fat, lean mass, and osteoporosis risk in 6 minutes. | Women 50 +, men 60 +, athletes, weight-loss patients. | Every 2 yrs (or yearly during rapid weight change). | *We coordinate colonoscopy, mammography, low-dose CT for smokers, prostate & thyroid ultrasound, and genetic carrier panels through trusted partners and will advise individually at your visit.* --- ### 3) What to do next 1. **Check your vaccine record**—if you haven’t had a pneumonia shot or completed the two-dose Shingrix series, call us at **818-996-4100** and we’ll reserve a vial. 2. **Schedule a preventive-care visit** where we’ll review your personal and family risk profile, order the right mix of tests, and craft a game-plan that keeps you thriving. 3. **Stay curious**—subscribe to my free newsletter for monthly heart-health pearls and science-made-simple: **substack.com/@afshineemrani**. Your body is an orchestra of 40 trillion cells performing a symphony every second. My mission is to keep that music playing—clear, strong, and joyous—for decades to come. **Blessings and good health,** *Afshine “Ash” Emrani, M.D., F.A.C.C.* Assistant Clinical Professor, UCLA David Geffen School of Medicine Castle-Connolly “Top Doctor” (since 2008) • LA Super Doctor (since 2010) • Top 100 Doctors in America (2024) 18370 Burbank Blvd., Suite #401 • Tarzana, CA 91356 Tel 818-996-4100 | Fax 818-996-0842 *P.S. Prevention works only when it’s personal. Let’s design the plan that fits **you**.* [1]: https://www.cdc.gov/pneumococcal/hcp/vaccine-recommendations/risk-indications.html?utm_source=chatgpt.com "Summary of Risk-based Pneumococcal Vaccination ... - CDC" [2]: https://www.cdc.gov/shingles/hcp/vaccine-considerations/index.html?utm_source=chatgpt.com "Shingles Vaccine Recommendations - CDC" [3]: https://cleerlyhealth.com/press/ai-qct-predictive-power-for-women-acc25?utm_source=chatgpt.com "Cleerly Unveils Groundbreaking Late-Breaking Clinical Trial Results ..." [4]: https://www.acc.org/Latest-in-Cardiology/Articles/2022/10/04/13/38/Comparing-Guideline-Recommendations-of-Statin-Use-For-the-Primary-Prevention-of-ASCVD?utm_source=chatgpt.com "Comparing Guideline Recommendations of Statin Use For the ..." [5]: https://www.heart.org/en/-/media/Files/Professional/Quality-Improvement/Lpa/Clinicians-Guide-LPaFAQFINAL.pdf?sc_lang=en&utm_source=chatgpt.com "[PDF] Lipoprotein(a) Testing - American Heart Association" [6]: https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-and-machine-learning-aiml-enabled-medical-devices?utm_source=chatgpt.com "Artificial Intelligence and Machine Learning (AI/ML)-Enabled ... - FDA" [7]: https://grail.com/galleri-test/?utm_source=chatgpt.com "Blood Test for Cancer Screening | Galleri®"
