For primary prevention patients with a coronary calcium score above the 75th percentile or >300, a high-intensity statin is considered, aiming for an LDL-C less than 70 mg/dL, with consideration for PCSK9 inhibitors if significant plaque is present.

“if it's a man over 40 or women over 50 get a coronary calcium score you know if they're above the 75th percentile I'm also thinking high intensity Statin and aiming for an LDL less than 70 which is also consideration of pcsk9 Inhibitors even in primary prevention patients if they have significant plaque you know very high calcium scores above 300”