With CAC score 3.6, should I start taking statin?

LDL should be less than 100!
https://scienceinsights.org/what-should-your-ldl-be-healthy-ranges-explained/.

Thank you for sharing.

If I’m not mistaken, a CAC score of 3.6 implies minimal calcification. And while I agree with @lenmayo regarding your ldl should be below 100, an advanced ldl test would tell “the rest of the story.” An ldl reading of 132 isn’t that bad if the majority of it is of the large variety. Conversely, if the majority of your ldl is of the small, sticky variety, your reading should probably be below 75.

Best of luck.

@csrb7007 Depending on your age, those scores might suggest doing absolutely nothing. For example, if you're only 40, yeah, you should be considering at least one measure to reduce those numbers. If you're already 80, not so much, unless you have a familial and genetic probability of reaching 90-95...in which case, again, it's probably worth about five years worth of statin therapy. Note that this is just my opinion, not knowing anything else about you, and having no training in medicine at all.

Stains have their fans on both sides of the counter, but they also have some serious detractors. There are alternatives that may actually be a better fit. Ask your doctor/cardiologist about Repatha and about Ezetimibe.

Your numbers are not terrible…mine are similiar…the most concern is you have LPa…and APOb…I also do. With that number the doctors want all of your numbers to be very low….LDL under 40 for some doctors and under 55 for others. Your CAC score only shows calcified plaque…not the soft sticky kind. Your LPa makes your blood stickier and APOb pushes it into the artery walls. Your ApO b means you have carriers that transport your cholesterol into the artery walls more so than others. I would definitely consider a statin and or Repatha. I am on both. Not to scare you but I am 69 and exercise 5 days a week…in good shape…play tennis etc and I had a heart attack last Oct. i was shocked. It turns out that diet, exercise and medication do not help LPa…it is totally genetic. Therefore doctors want all the rest of your lipid numbers super low. Now my kids have to be tested. So I would advise speaking with a cardiologist…and I am sure they will want you on some kind of medication.

@alana924
Thanks for your inputs. My Lp(a) unit is nmol/L Not mg/DL. 80 nmol/L Lp(a) is borderline high than the optimal one at less than 75 nmol/L
What are your CAC score and Lp(a)?

My CAC was 220..my LPa is 228…so both higher than yours…my APOb was low…

Not to be forgotten in all of this is the systemic inflammatory load. Healthy systems don't generally accumulate plaque. Inflamed endothelial linings everywhere in the body, including in the vasculature, are going to invite the deposition of plaque or scarring. It is under the inflamed lumen layer in blood vessels that the plaque forms. So, leaving aside all the genetics and phenotypical influences as we go through life, minimizing systemic inflammation is exceedingly important. This is one of the benefits of statins: they help to reduce inflammation.

@alana924 I have it as well , diagnosed 15 years ago, I too am active but we cannot lower this ourselves. there are several medications in trial study .. I am praying I can try one of them . Currently I'm on repatha (statins make it impossible to walk without severe pain ) repatha keeps my LDL around 44 to 50 .my CAC score is 104

Regarding "...high soluble fiber diet..." , as far as I understand, high fiber diet is a good idea in general, for good health (avoiding heart disease, excess weight, cancer, death). What ever fruits, veggies, legumes,and whole grains you like and your dietitian might suggest, if you have an RD.
As for the statin/meds, perhaps discussion of your situation and your Prevent calculator score will help decide a plan with your Doctor. Best wishes