This study is testing a new drug called **maridebart cafraglutide** to see if it can help people with heart disease and who are overweight or obese. The goal is to find out if this drug is better than a placebo (a fake treatment) at reducing heart problems and deaths. *Atherosclerotic Cardiovascular Disease (ASCVD)* is when blood vessels get clogged with fat, which can lead to heart attacks or strokes. *BMI (Body Mass Index)* is a way to measure if someone is overweight. To join the study, you must be 45 or older, have a BMI of 27 or higher, and have a history of heart disease. You cannot participate if you have had a recent heart attack, certain types of diabetes, or a history of severe liver issues or certain cancers. **Key Points:** - The study is for people aged 45 and above with heart disease and a BMI of at least 27. - Participants cannot have had recent major heart events or certain types of diabetes. - The study assesses if the drug reduces heart problems and deaths better than a placebo.