Aggressive Risk-Prevention Therapies for Coronary Atherosclerotic Plaque (ART-CAP)
The purpose of this study is to evaluate the effect medication on your heart. All patients between 18-80 years of age, at intermediate or high risk for coronary heart disease (calculated based on age, gender, race, and history of smoking, diabetes, high blood pressure, high cholesterol, family history of early coronary heart disease) with/without symptoms suggestive of heart disease, including chest pain or shortness of breath on exertion, will be selected to take part in this study. CT scan will be used to assess to see if the prescribed treatment changes the blood vessels in heart.

The investigators are doing this study because they want to develop better tools to predict, diagnose, and treat coronary heart disease. This research will help improve care for patients with coronary heart disease by evaluating heart vessel narrowing and improving the decision-making for treatment.
- EligibilityCriteria: Inclusion Criteria:  Non-obstructive atherosclerotic coronary artery plaque (stenosis of 0-39% or stenosis of 40-69% with FFR-CT >0.8) in a major epicardial vessel > 2 mm in diameter.  Exclusion Criteria:  coronary/PAD/carotid revascularization or ischemic stroke or TIA within 6 months prior to enrollment Valvular heart disease of moderate or worse severity or requiring interventional procedures or surgery LVEF <35% in the past 12 months Pulmonary hypertension with PASP>50 mm Hg in the past 12 months Myocarditis or pericarditis in the past 12 months Known Cardiomyopathy (hypertrophic, infiltrative, restrictive, dilated, etc.) Heart failure NYHA class 3 or 4 Hospitalization for heart failure in the preceding 6 months Life expectancy of <1 year An organ-transplant recipient or if felt to require listing for solid organ transplantation during study status Inability to give informed consent Active malignancy (except basal cell skin cancer) Cirrhosis ESRD Pregnancy or planning to conceive during the study period Known intolerance or perceived contraindication to any of the study drugs during the study period including statins or aspirin if indicated eGFR<30 ml/min/m2 Inability to receive iodinated contrast for CCTA Chronic immunosuppression therapy Uncontrolled psychiatric illness - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - MaximumAge: 80 Years - StdAgeList: Adult, Older Adult