Yes, it's not significantly associated with a lower risk of ACM, but that doesn't mean they don't increase ACM risk. It just means that in these relatively short RCTs, a significant finding on a very insensitive endpoint like ACM was not found. That's not surprising, you wouldn't necessarily expect to see such a finding. For that you'd want longer or larger RCTs (unlikely due to cost) or prospective cohort studies (which do show a significant effect on ACM).
As noted elsewhere, this is contradicted by other studies, one of which you cite, which find that SFA reduction is not protective if SFA is substituted with CHO (only if it is substituted with PUFA).
Overall, there is no good concluaion to be made, other than that there is a tiny effect from consuming less SFAs, maybe.
As I’ve already pointed out to you, that’s not a contradiction when the studies are looking at CHO as a whole and not disambiguating between whole grain and refined carbohydrates.
If you think a 21% reduction in one of the largest killers in the western world is a tiny effect, then that’s genuinely laugh-out-loud funny.
It’s like someone providing evidence that exercises decreases mortality risk in humans and countering with “but exercise induces oxidative stress at a cellular level so we shouldn’t do it.”
It’s just turning the evidence hierarchy on its head. I’m curious why you would interpret evidence in this way - why are mechanistic studies with incredibly low internal validity more convincing than RCTs and prospective cohort studies to you?