Pathological examination of coronary arteries from historical texts suggests LDL is not the primary driver of atherosclerosis.

“there's a lot of observations that don't line up there are several there actually may be up to 12 types of lesions and some of them actually have less LDL in them than a healthy artery wall and just the timeline doesn't line up like people like to claim that fatty streaks that are seen in childhood or the start of atherosclerosis but the evidence suggests that those are actually a completely separate phenomenon that are not related to what later become complex lesions that are prone to rupture”