With the advancement of revascularization technology, emphasis on smoking cessation and healthy lifestyles, and incorporation of alternative guideline-directed medical therapy such as statins, beta-blockers, and sodium-glucose co-transporter 2 (SGLT2) inhibitors, those at highest cardiac risk can be detected early and intervened upon sooner contributing to the diminishing role of aspirin in primary and secondary prevention of ASCVD. This evidence concerns the gene SLC5A2 and atherosclerosis.