I have already discussed the role of cholesterol in ASCVD and MI and I have described how obesity and particularly metabolic syndrome increase risk for dangerous and abnormal blood cholesterol levels, how those levels influence risk and finally how that risk can cause a full-blown MI or heart attack. That much has been established.
What is worse is this: that obesity is an INDEPENDENT risk factor for heart attack. That is to say that above and beyond the heart disease risk that obesity causes through abnormal blood lipids, it causes additional risk that exists even in obese people with normal levels of blood fats. THAT is the very bad news. Obesity is a direct and and indirect (through cholesterol) risk factor for heart attack.