New diagnostic tools like Lp(a) and coronary calcium scans are sometimes incorporated into practice without large-scale evidence-based trials.

“There are litany of examples like LP little a was something I didn't pay attention to until the past few years. Coronary calcium scans. If somebody came to see me with a coronary calcium scan, 10 years ago, I would say, I wish I didn't have this information, but I never ordered one before. seven to eight years ago. So there are lots of examples of things that I didn't use to do that I've now incorporated into my practice. And I'm doing so without that safety belt of evidence basis that we're used to, right? There's not gonna be a Orbita-like trial to help me decide whether I should be aggressive with lipid lowering in a 35-year-old. That's not gonna happen with primary prevention.”