I can relate to your situation. After my normal cardio appt in 2018 he suggested that I have my CAC tested (that day). It came back at 1015 (age 61). He called me that same afternoon and scared the hell out of me. He told me that I had a 20-25% chance of a major cardiac event per year and ordered a stress test for the next day, which I passed. I changed cardiologist because he was so fatalistic.

Due to bad genes I have been on various statins for over 30 years (father died at 55 following second open heart when I was 15) and have always controlled my cholesterol levels (which started at 376!) I also take 10 mg of zetia with my 20mg of rosuvastatin.

My new cardiologist recommended a second CAC scoring in Nov. 2022 (CTA with contrast). Like you, the vast majority of my calcium is in LAD and RM. Surprisingly I only had a CAC of 1185, much lower progression than I expected. However, since there was stenosis over 50% he had ordered that an FFR (fractional flow analysis). This calculates a value that measures blood flow rather than just degree of blockage. Most indicate that if this falls below 0.80 that you should be stented, although I have seen references that state 0.75. Part of my LAD was down to 0.76, but the cardio said it wasn't stentable.

Even with all of these test results I am still asymptomatic at 68. So many on these threads panic and go in search of some magic bullet to reduce calcium and go on crazy diets or spend tons of money on a variety of dubious supplements. I eat/drink what I want (I like my red meat and carbs) and have never taken any supplement except for vitamin D2 since I had a deficiency.

Once you have a high CAC like us there is not much you can do to change your fate. I am all for enjoying life and think that a positive attitude is more important than any other factors. Easier said than done!