Not a doctor but what is obvious is there are two types of heart attacks. One is a clogged artery and the other an electrical problem. Sometimes it happens in combination. From what I read nearly 50% of clog type heart attacks happen to people with low cholesterol or favorable numbers. If cholesterol is the magic indicator how do they explain the other clogs? Yes, I know about lipid ratios. Sometimes I wonder if we truly know how to prevent heart attacks definitively. We do know that fit people have much lower risk of heart attack than unfit people. Other risk factors are high blood pressure, high sugar, high triglycerides, and visceral fat. Genetics trumps all. There are a few fat guys that have never exercised that make it into their 80's. An indicator some doctors feel is really important is cardiac inflammation and it's a blood test to find out the number.