Inclusion Criteria:  Age: ≥ 50 (men) or ≥ 55 (women) Low-density lipoprotein cholesterol (LDL-C) > 90 mg/dL  Stable coronary artery disease (without plan to undergo revascularization before randomization) defined as one or more of the following:  Abnormal nuclear perfusion imaging  At least moderate ischemia involving >10% of the LV myocardium or Global coronary flow reserve (CFR) <1.8 or Stress myocardial blood flow (MBF) <1.8  Abnormal coronary angiography (invasive coronary angiography or coronary computed tomography)  > 50% stenosis in > 2 coronary vessels or Diffuse atherosclerosis in a 3-vessel distribution  Elevated coronary calcium score  CAC >100 + >1 ASCVD risk factor CAC >300 If the patient is on a statin they must be on a stable dose for at least 3 months prior to enrollment.  Exclusion Criteria:  History of myocardial infarction or stroke CABG < 3 months prior to screening Homozygous familial hypercholesterolemia History of cardiac transplantation LV ejection fraction < 40% or New York Heart Failure Association (NYHA) class III-IV for angina and/or dyspnea. History of infiltrative or hypertrophic cardiomyopathy Severe valvular disease Uncontrolled or recurrent ventricular tachycardia Fasting triglycerides > 500 mg/dL GFR ˂ 30 mL/min/1.73 m² Current use of a PCSK-9 inhibitor Currently pregnant or breastfeeding Contraindication to receive vasodilator agent Latex allergy