Resolves as YES if there is a credible clinical trial that demonstrates an intervention significantly reducing the progression of atherosclerosis before January 1st 2035.

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In the context of this question, "significantly reducing the progression of atherosclerosis" must demonstrate at least two of the following criteria:

• Reducing the CAC (Coronary Artery Calcium) score progression rate to 5% annually or lower (on average).

• Reducing the buildup of non-calcified plaque compared to statins plus PCSK9 inhibitor therapy by a factor of at least 5 over a time period of at least 2 years.

• Reducing the buildup of calcified plaque compared to statins plus PCSK9 inhibitor therapy by a factor of at least 5 over a time period of at least 2 years.

• Demonstrating a statistically significant reduction in the buildup of plaque in other organs (non-heart) of the body compared to statins plus PCSK9 inhibitor therapy over a time period of at least 2 years.

  
  

The intervention can be any combination of therapies, which may include but are not limited to statins and PCSK9 inhibitors. The clinical trial must include at least 2000 adults, with no more than 70% belonging to the same ethnic group, ensuring at least 30% representation from other ethnic groups. The trial should ideally be a randomized, double-blind, placebo-controlled study or a meta-analysis of such studies.

If a clinical study demonstrates at least two of the above criteria with respect to another therapy, or set of therapies, that are known to slow atherosclerosis to a greater extent than "statins plus PCSK9 inhibitor", then this also qualifies.

The trial cannot focus exclusively on a specific subset of the disease population (e.g. hypercholesterolemia), it must be roughly representative of either the general adult population, the population with established ASCVD, or a subset with high risk factors. Cohorts selected based on symptoms, imaging data and prior events are also acceptable (provided these prior events do not put the patients in very specific categories like heart transplants. Prior stents/angioplasty would qualify since this is much more common). Any median age above 18 is acceptable, provided the cohort includes at least one patient older than 70 and at least one patient younger than 45.