A study by Dave Feldman and Matthew Budoff examined atherosclerosis progression in individuals with elevated LDL compared to those without.

“basically what we see with specifically to Dave Feldman's study they had people with a mean ldlc so the average ldlc was 272 milligrams per deciliter and a Max of 591 so something to put into perspective here is this is not total cholesterol this is just LDL cholesterol and in these in these studies HDL also tends to be high so total was significantly higher and what they see is that there's no relationship in this study between ldlc elevations and plaque formation they're not actually seeing any any relationship and there there's an interesting graph where they show like you can see the LDL values you can see the plaque scores and they're not correlated by any capacity some of the highest scores have zero plaque burden so that's the first thing with with these people with very high ldlc levels and we're not seeing this the the positive or the CAC scores greater than zero or we're not seeing elevations in plaque bur and overall as the CCTA or the CAC scores which is that's a huge that's that's a huge uh thing to see because ideally if you have this if LDL is directly causitive in cardiovascular disease you would see you would assume a linear relationship or some type of relationship not necessarily always linear where the higher levels that you get the higher the higher the plaque burden and you're not actually seeing that”