STREAM Trial - Biomarker

Inclusion Criteria: * ≥70 years of age * Multimorbid with ≥2 coexistent chronic conditions (defined by ICD-10 codes) with an estimated duration of 6 months or more based on clinical decision, besides dyslipidemia treated by statins * Taking a statin for ≥80% of the time during the year before baseline Exclusion criteria: 1. Secondary prevention based on previous large statin trials, defined as: * History of myocardial infarction type 12 (NSTEMI/STEMI) OR * History of unstable angina, defined as ACS symptomatic at rest, crescendo or new-onset angina (CCS 2 or 3) without ECG or cardiac biomarker changes (based on available documents) OR * Stable angina pectoris with a documented ischemia on a stress test or with a significant coronary disease defined as a coronary stenosis \>50% OR * History of percutaneous coronary intervention (balloon or stent) or coronary artery bypass graft OR * History of ischemic stroke OR * History of Transient Ischemic Attack, defined as transient neurological deficit without diffusion restriction in MRI OR * History of carotid revascularization (stent or bypass) OR * History of peripheral arterial disease requiring revascularization (stent or bypass; Fontaine IV) 2. Aortic disease that required a vascular repair or aortic aneurysm with a maximum diameter \>5.5 cm (men) or \>5.2 cm (women) based on available documents 3. Diagnosis of familial hypercholesterolemia based on Dutch lipid score ≥6 based on available documents (LDL-c, Family History, Personal History) 4. Elevated risk of death within 3 months after baseline, defined as: * Hospitalized patients planned for palliative care within 24h of admission OR * Hospitalized patients with a Palliative Performance Scale (PPS) level \<30% (based on situation at least 1 month before hospitalization), this corresponds to an estimated survival of 43% after 3 months; OR * Patients with an advanced metastatic cancer prognosis of ≤20% survival rate within 1 year after baseline (based on an online tool: https://cancersurvivalrates.com)