A Coronary Artery Calcium score of 0, triglycerides under 100 mg/dL, and HDL over 70 mg/dL may allow for the prudent avoidance of pharmacological treatment.

“if your CAC is zero if you have no plaque burden it it almost doesn't matter what your LDL is you know based on the studies we've looked at you know be insulin sensitive”

“so 45% of these people with FH with familiar hyperemia and elevated ldlc levels are not seeing CAC scores greater than zero and they're middle-age people this is not in young young familiar Hy cholesterol with people so you have you have incident you have studies like this then there's a variety of other studies where basically there's some really interesting ones where they're stratifying people's uh their LDL values into different categories and then they're basically seeing that in each category whether ldlc was 77 milligrams per deciliter or whether it was 190 milligrams per deciliter again LDL not total cholesterol if their CAC scores were zero they basically had a minimal risk of cardiovascular events and and uh they weren't really like they weren't really showing increased heart attacks and all this type of stuff with with even with these high ldlc levels”

“when you un so the process of the formation of plaque involves the movement of LDL particles generally modified LDL particles across the vascular wall that basically triggers an inflammatory response in the vascular wall and then you have the immune system come in and the macras start to interact with the LDL gobble it up and create these lipid loaded foam cells and now you start to get plaque formation”

“There's actually a recent study done with coronary artery calcium scores and in those people that had a coronary artery calcium score of zero, there was no connection, no relationship between levels of LDL cholesterol and cardiovascular disease.”

“If my calcium score is 0, my triglycerides are under 100 and my HDL is over 70, it is not reckless to decline pharmacological treatment.”