Accelerated atherosclerosis and early cardiovascular events can occur in individuals with normal apob, triglycerides, and no familial hypercholesterolemia or high Lp(a), suggesting a role for polygenic risk factors or other mechanisms.

“so you see atherosclerosis that runs in families and they there's not an obvious cause right they don't have fh they don't have lp little a and frankly their apo b is harboring around the 20th or sort of called the 50th percentile of the population but they disproportionately uh get afflicted young so they're all having first events before 60.”