A Phase 1b Study to Assess the Safety, Tolerability, and Pharmacodynamics of AZD4144 in Participants With Established Atherosclerotic Cardiovascular and Chronic Kidney Disease.

This is a Phase 1b, randomized, double blind, placebo-controlled study and will be conducted in participants with established ASCVD and CKD with persistent inflammation (High-sensitivity C-reactive protein [hsCRP] > 2 mg/L and eGlomerular filtration rate [eGFR] ≥ 30 to < 60 mL/min/1.73m2). The participants will be randomized in the 1:1 ratio to either receive treatment with AZD4144 or placebo.

The study will be comprised of:

• A screening period of 28 days
• Treatment period where each participant will either receive oral dose of AZD4144 or placebo for 28 days.
• A follow-up visit (Day 35 ±1) and a Final Follow-up (on Day 56±1) post first dose administration.

The total duration of the study will be approximately 12 weeks.

Key Inclusion Criteria:

• Participants with established ASCVD history of one or more of the following

• Prior Myocardial infarction (MI) (>60 days from index event) or coronary revascularization procedure like coronary stenting or Coronary artery bypass graft (CABG)
• Prior ischemic stroke (>60 days from index event)
• Symptomatic Peripheral Arterial Disease
• Chronic kidney disease defined as eGlomular filtration rate (eGFR) ≥ 30 to < 60 mL/min/1.73 m2
• Serum hsCRP > 2 mg/L
• Body mass index ≥ 18 to ≤ 45 kg/m2
• All females must have a negative pregnancy test at the Screening Visit and at the randomization visit

• Sexually active male participants with partner of childbearing potential must adhere to the contraception methods
• Females of childbearing potential must not be lactating and if heterosexually active must agree to use an approved method of highly effective contraception
• Females of non-childbearing potential must be confirmed at the Screening visit

Key Exclusion Criteria:

• History of malignancy within the last 5 years
• History of MI, coronary revascularization, stroke or revascularization for peripheral arterial disease in the 60 days prior to Screening
• Active systemic infection within 30 days
• Clinically significant active and chronic infections within 60 days prior to randomization
• Clinically significant recurrent infection (≥ 2× during the last 12-month period).
• Renal transplant participants, participants on dialysis, and those with a history of acute kidney injury in the past 12 month