What would you do in my situation? Should I be worried?

Cardinal rule: a second opinion, like time spent on research, is seldom wasted. If nothing else, you'll have a confirmation, and if the two are even somewhat disparate, you can then decide which way to look at it on your own behalf.

The LAD score isn't great, but nor is it cause for panic. It's just a photo, a snapshot, of what extent of calcification is extant.

A statin, aside from its anti-lipid capability, is also a mild anti-inflammatory. You may have some systemic inflammation, maybe just in and around the LAD. Deposition of plaque is exacerbated by inflammation, notably of the endothelial linings of arteries. So, maybe it wouldn't hurt to ask your 'second opinion' what he/she thinks of a CRP test to find out if you are also at the 75%ile or higher in terms of inflammation? Something to think about, or certainly to run past your cardiologist.

Finally, despite what may be your scrupulously excellent diet and fitness regimen, your genetics may predispose you to producing a kind of LDL, size and stickiness, that adheres particularly well to your LAD (for some reason well beyond me), but not to other blood vessels. BTW, while I'm thinking about this, it wouldn't hurt to learn what your carotid arteries look like if they were not part of this scan. A Doppler ultrasound will show their current extent of deposition.

Given circumstances many target LDL of closer to 50 (vs 100). You didn't mention triglycerides? Total cholesterol of around 100 also a reasonable target. Vascepa?

you said
"It can be slowed with some treatment, maybe including backing off on the fruit. Fruit has a lot of fructose, and it's a demanding conversion for the liver to change it to glucose, which spikes insulin levels. High serum sugar levels cause damage to the endothelial lining of arteries due to inflammation, and inflamed tissues are a better surface for cholesterol to adhere to.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8267750/"
The article you reference is based on fructose sugar from soft drinks.
and I quote "The alarming increase in metabolic syndrome and comorbidities can only be attenuated if the consumption of fructose, mainly in soft beverages, is significantly reduced worldwide"
Fructose from whole fruit it metabolized very differently that fructose sugar used in soft drinks and does not represent the threat you imply that whole fruit fructose is = to fructose added to soft drinks.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6247175/
Food sources of fructose-containing sugars and glycaemic control: systematic review and meta-analysis of controlled intervention studies
"Energy control and food source appear to mediate the effect of fructose-containing sugars on glycaemic control. Although most food sources of these sugars (especially fruit) do not have a harmful effect in energy matched substitutions with other macronutrients, several food sources of fructose-containing sugars (especially sugars-sweetened beverages) adding excess energy to diets have harmful effects. However, certainty in these estimates is low, and more high quality randomised controlled trials are needed."

"...However, certainty in these estimates is low, and more high quality randomised controlled trials are needed."

If you want to put up youtube stuff, here as an 80 minute lecture By Dr. Robert Lustig MD University of California Professor of Pediatrics that is pure science.

BTW I watched a couple of your links and amazingly a couple of them said the fructose from whole fruits generally is good thing esp because the rise in sugar is much slower due to slower metabolism.

Get an “LP little a” blood draw/test and find out if you have coronary artery disease CAD. If you do and with your calcium test, go to the cardiologist and find out if you have any arteries blocked. That’s really the main concern you didn’t say what your cow what your cholesterol was. CAD runs in my family so I was able to get the test easily and indeed I do have it unfortunately it’s hereditary. So fortunately my whole life I’ve been really concerned about eating a low-fat diet and staying healthy. I have three clear arteries and one artery that’s 1/3 blocked. I’m 67 years old. I outlived my other relatives so I’m doing pretty good and my arteries are in great shape compared to my dad who had a heart attack at 58 and swam three times a week and had three arteries completely blocked and had to be on statins the rest of his life. He died a normal life span of 87 years old. I found it was really easy to lower my cholesterol by just putting more fish in my diet when I went off the fish my cholesterol shot back up. Because of the CAD I also get LEVEQIO injections twice a year which are going to help Avoid plaque buildup. I wouldn’t worry so much about numbers I would worry about what condition your arteries are in and your heart. They seem to be in good condition but I didn’t see what your arteries look like. Get that checked get a cardio doctor. Good luck.

'...BTW I watched a couple of your links and amazingly a couple of them said the fructose from whole fruits generally is good thing esp because the rise in sugar is much slower due to slower metabolism....'

Exactly. It's better. It's still sugar...no? Even more, it's fructose, the most problematic of all sugars. And if a person is consuming a fair amount of fresh fruit and berries...... (and here I stop talking and raise my eyebrow while continuing to watch you., knowing that you'll realize that what I posted way back there was perfectly sensible and worthy of consideration, which is all I ever suggested).

Based on your history, almost all docs would recommend you be on a statin - are you not?

Nope, not on statin. I was prescribed one but had a bad reaction in 3 weeks. (muscle pain weakness). The Vescepa (saw you mentioned it) was worthless in my case. Couldn't get my cholesterol to budge from 240!
What DID work was the real deal - upping my intake of fish! Only takes 2-3 months and my very stubborn cholesterol will drop 40 points. I wrote another lengthy post today about my cholesterol with numbers. My dad was on statins for two decades. Although it controlled his cholesterol, it did not stop the plaque build up! He had 3 major bypass surgeries at 58, 72 and 80. Angioplasties and stints in between. Then had TIA's and finally a major stroke! But his cholesterol was 169! Its not your cholesterol but the ratios of LDL to HDL and other indicators.
I noticed a convo about fructose above. I have IBS and I can't digest fructose in fruits because of the oligosaccharides, so I went back to a regular ole white sugar after abstaining for 45 years.
I have familial CAD and that plays a part in my body depositing plague even when denied fats. It still finds a way to make them. That is what science teaches us. (I had nutritional chemistry in college) If you make the mistake of giving your body components of cholesterol, it will make up the plaque much easier than if you just ate the cholesterol outright. Our body has a unique "signature" for cholesterol. So it must break down that egg you ate -- before reconstituting it to your body's unique cholesterol. People don't understand digestive nutritional chemistry and that it's not the 'thing" you eat - it's how the body metabolizes it and which part of the body, at what point in the digestive process, it gets digested. We really must understand how to understand the research articles as well.

I suspect most of your father's plaque build up from from earlier in life - and, the statins probably did their job by reducing plaque, and by calcifying already present plaque.

While I know you feel certain about ratios, I would urge you to get your cholesterol under control with injectables.

And to Vascepa - jury still out on full effects, but its core purpose is usually to reduce LDL.