Can cholesterol drugs shield the heart during melanoma immunotherapy?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Provision to sign and date the consent form. * Stated willingness to comply with all study procedures and be available for the duration of the study. * Be a male aged ≥55 years or a female aged ≥65 years. * For those able to bear children, documentation of menopausal status via approximate last menstrual period or hysterectomy due to contraindication of pregnancy for the CCTA procedure. * Have a melanoma diagnosis without prior ICI use and planning to start on ICI therapy (PD-1, PD-L1, CTLA-4, LAG3) as standard of care for their cancer. * Plaque stage ≥ 1 on screening CCTA. Exclusion Criteria: * Any prior major cardiovascular event, defined as myocardial infarction, stroke, coronary revascularization, or other major cardiovascular event determined to be significant by the principal investigator. * Meeting any of the standard CCTA contraindications listed below: * Allergy to iodinated contrast or history of contrast-induced nephropathy * Renal insufficiency (eGFR \< 45 mL/min/1.73 m2 by the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) or Modification of Diet in Renal Disease (MDRD) equation). A current eGFR value (collected/calculated within 3 months from screening visit) is required at baseline. * Active arrhythmia (atrial fibrillation, atrial flutter, frequent premature atrial, or ventricular contractions) with poorly controlled rate (i.e., \> 80 beats per minute). EKG must be performed within 1 year of screening visit. * Hemodynamic instability * Weight \> 400 lbs. (181 kg) or above manufacturer-recommended limit for scanner and table, whichever is lower * Thyroid cancer in the previous five (5) years or planned radioactive iodine treatment * Pregnancy * Inability to hold breath for \> 10 seconds * Contraindication to dosing with beta blocker as needed or nitroglycerin prior to CCTA procedure * Inability to cooperate with scan acquisition and/or breath-hold instructions * Any other factor that, in the opinion of the investigator, would increase participant risk or increase the chance of an uninterpretable CCTA * If a patient's fast LDL-C is \> 190 mg/dL, this is consistent with underlying familial hypercholesterolemia, and they will not be eligible for the study. * If a patient's CCTA demonstrates previously undiagnosed obstructive coronary disease, they will not be eligible for the study. Obstructive disease will be defined as \>50% obstruction in the left main coronary artery, or \>70% obstruction elsewhere in the coronary tree.