Participants with the rs5498 AG or GG variants and high ICAM1 mRNA expression (≥3.12) had 2.49 times the risk (95% CI [1.42–4.38], P = 0.001), and those with a high LDL-C concentration (≥3.36 mmol/L) had 2.09 times the risk (95% CI [1.19–3.66], P = 0.010) of developing ASCVD compared with those with low ICAM1 mRNA and LDL-C levels. The gene discussed is ICAM1; the disease is atherosclerosis.