Atherosclerosis is a disease of the tissue, not just plasma lipid levels.

“you've got someone with a massive atheroma right in their artery here and it's just about to burst it's enormous it's catastrophic just down a millimeter away or even across the wall the endothelium and the artery is in perfect health with no issue that person at the same LDL particle count why is atherosclerosis massively focal it's in specific spots you've got the same particle counter out your whole vasculature but some certain spots get massive atheroma and right beside them the artery wall is beautiful I mean it just clearly screams that it's not the big factor you know”