We've known for a while that inflammation is an independent risk factor for heart disease, alongside LDL cholesterol (or ApoB), Lp(a), and so on. Inflammation is most commonly measured by by hs-CRP or IL-6.

The ZEUS trial tested an anti-inflammatory injection (ziltivekimab). These phase III results showed a hazard ratio of 0.99, i.e., no effect.

This is evidence for a lipid-first model -- i.e., lipids drive oxidation, which then triggers inflammation.