Management of high CAC score

Thanks for asking—here’s the bottom line: a high CAC percentile means you have a higher plaque burden than peers, but being asymptomatic with LDL 48 on statin therapy is exactly the right path. You do not need a stent unless there are symptoms (exertional chest pressure, breathlessness, jaw/arm pain) or objective evidence of significant ischemia on testing. Stents are for symptom relief or clearly high-risk blockages, not for silent calcium scores. The key is aggressive prevention: keep LDL very low (you’re there), control BP, don’t smoke, exercise, and optimize weight/sleep. If there’s any doubt about silent ischemia, a stress test with imaging can clarify, but routine stenting is not indicated in your situation.