PRE-EMPT: Prospective RandomizEd Evaluation and Management of Premature aTherosclerosis

Exclusion Criteria

• •1. Clinical diagnosis of ASCVD including coronary artery disease (CAD), peripheral arterial disease (PAD) or cerebrovascular disease (CeVD)
• •2. Current symptoms thought to be from CAD
• •3. PREVENT ASCVD 10-year risk ≥5% (if known)
• •4. Diabetes Mellitus (DM) as defined by any of the following: DM diagnosis in the medical record or HbA1C of 6.5% or greater. (if known)
• •5. LDL-C ≥190mg/dL (most recent, if known)
• •6. HIV (if known)
• •7. Severe liver disease or untreated Hepatitis C infection (if known)
• •8. Pregnancy, lactation or intending to become pregnant during the study period of 2 years
• •9. eGFR \<45mL/min/1.73m2 (if known)
• •10. AST or ALT \>1.5x the upper limit of normal (if known)
• •11. BMI\>40kg/m2 or unable to have a CCTA scan for any reason
• •12. Allergy to iodinated intravenous contrast or other contraindication to CCTA
• •13. Current or previous use of lipid lowering therapy or colchicine
• •14. Known allergic reactions or sensitivity to the study intervention(s), including known intolerance or contraindication(s) to statin or colchicine, or long-term use of medications that are contraindicated with colchicine or rosuvastatin.
• •15. Systemic cancer undergoing active treatment
• •16. PREVENT ASCVD 10-year risk ≥5%
• •17. eGFR \<45 ml/min/1.73m2 per baseline labs, (2021 CKD-EPI equation will be used if multiple options are available)
• •18. Hemoglobin A1c ≥6.5% per baseline labs
• •19. LDL-C ≥190mg/dL per baseline labs
• •20. Severe proximal coronary artery stenosis as determined by the central core lab (≥50% left main or ≥70% proximal major coronary artery stenosis)
• •21. Known contraindication to follow-up CCTA (e.g., new IV contrast allergy discovered during the baseline CCTA)
• •22. Individuals who are excluded based on any of these factors will be notified as to the reason for exclusion and encouraged to follow-up locally to address this medical issue with their treating physician.