Inclusion:  patients ≥ 18 years old AND admitted to the BWH Cardiovascular Medicine Service with a diagnosis (primary or secondary), medical history entry, or problem list entry of ASCVD (acute coronary syndromes, a history of MI, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease) AND most recent (within 1 year) or current LDL-C value greater than 80 mg/dL AND on a statin but not on ezetimibe and/or PCSK9 inhibitor will be potentially eligible for randomization  Exclusion:  -already receiving PCSK9 inhibitor therapy