Feasibility of Combination Therapy With Low-dose Statin and Ezetimibe in Patients With Minimal Subclinical Atherosclerosis

1. Adult men and women between the ages of 30 and 79

2. Patients with video-confirmed minimal subclinical atherosclerosis who meet one or more of the following criteria:

   • Minimal subclinical coronary artery disease with less than 30% coronary artery stenosis on CCTA or CAG
   • Individuals with a coronary artery calcification index (CACS/CCS) between 0 and less than 100
   • Patients with carotid plaque detected on carotid ultrasound (diameter stenosis less than 30%) or intima-media thickness (IMT) of 1.5 mm or more, or a protrusion of 0.5 mm or more

3. Those eligible for reimbursement for statin/ezetimibe combination therapy at the time of registration, in accordance with the domestic guidelines for dyslipidemia treatment. In other words, the LDL-C reimbursement initiation criteria based on the patient's cardiovascular risk classification

   • Two or more major cardiovascular risk factors, and LDL-C ≥ 130 mg/dL

   • LDL-C ≥ 160 mg/dL with one major cardiovascular risk factor Registration will proceed only for those who meet the above salary criteria Table. Major Cardiovascular Risk Factors Category Major Cardiovascular Risk Factor Criteria

     1. Age Male ≥ 45 years old, Female ≥ 55 years old
     2. Family history of early onset of coronary artery disease onset in men at 55 and women at 65
     3. hypertension If hypertension is present
     4. Smoker Current Smoker
     5. Low HDL-C \< 40mg/dL Deduction: If high HDL-C (protective factor) is ≥ 60 mg/dL, deduct 1 from the number of risk factors
4. Those who have voluntarily given written consent to participate in this clinical study

Exclusion Criteria:

1. Individuals diagnosed with existing diabetes (Type 1 or Type 2 DM): HbA1c ≥ 6.5% or those taking diabetes medications (oral hypoglycemic agents or insulin)
2. Individuals with a coronary artery calcification index (CACS) of 100 or higher
3. Individuals with coronary artery stenosis of 30% or more on a CCTA or CAG
4. Individuals whose LDL-C levels are below the initiation criteria based on the number of major cardiovascular risk factors
5. Individuals classified as high-risk or ultra-high-risk (For example: acute coronary syndrome or PCI within the past year, or LDL-C target recommended \<55-70 mg/dL)
6. Persons with active liver disease or AST/ALT levels at or above three times the upper limit of the normal range
7. Severe chronic renal impairment (eGFR \<30 mL/min/1.73m² or dialysis)
8. Individuals who are hypersensitive to statins or the ingredient ezetimibe
9. Pregnant women, nursing women, or women of childbearing age who have difficulty using appropriate contraception