I finally was able to visit the lipids specialist. He was not worried about my 218 calcium score since I had been on Prevastatin for many years. As for the Repatha horrible GI side effects that literally put me in bed in horrid pain, he said that GI effects are “very rare” but very extreme. I was given Nexletol by my internist until I saw the lipids specialist, and I was honestly amazed at the overall (208), HDL, and LDL scores. Formally diagnosed with familial hypercholesterolemia, highly suspects Lp(a). More blood work scheduled, but trying a combo of Nexletol, Pravaststin, and possibly revisiting Zetia later. I took myself off aspirin (after reading in this site about GI issues-thank you!) and I may try taking low dose aspirin every three days if tolerated. Finally feel like I can fight again my family cholesterol genetics!