For a 62-year-old with symptomatic CAD on maximal statin therapy and a CAC score of 280, is a single 180-patient RCT showing slowed CAC progression on a surrogate endpoint sufficient to recommend MK-7 360µg daily now — given its benign safety profile and low cost — or does the paradox that statins themselves increase CAC while reducing events mean CAC slowing is uninterpretable as a benefit signal without hard-outcome data? | Synapse Debates