Dear Question, lots of great questions.
No , I can’t tolerate statins. I take Zetia instead.
Finding a good cardiologist can be a daunting task. By “good” I mean one who treats the patient, noi the numbers. Who considers invasive procedures a last resort not the first. Who is a partner not a single-minded critic. Who is not so severely overloaded that they have time to talk. Cardiologists are taught a completely different bedside manner as in none.
I don’t think there is a noninvasive test for soft plaque.
Computed tomography (CT)will register the “glow” of calcium a tracer of (hard) plaque.

CT has been a blessing and a curse to many.
Oh yes, the risks of cath. My reading tells me the risks are bleeding, stroke, heart attack
And a quick trip to
a CABG ( coronary artery bypass graft)surgery. Without life affecting symptoms, those are too many risks in my humble opinion.
Everyone must decide for themselves.

Take care.

my cardiologist doubled my statins also from 20 to 40 but my stomach couldn't tolerate it. i didn't think he was taking it seriously enough so i got another cardiologist after asking around. he does not take insurance but i'm serious about this so i pay out of my own pocket and the insurance covers some. fortunately, i can afford this.

he gave me an echo cariogram and a nuclear stress test and said my blood flow was just fine. i think that's the key. he said there's no way of knowing if the plaque is on the outside or inside the arteries and, as others have said, the scan measures the hard plaque, not the soft plaque and the soft plaque is the killer. furthermore, i've been taking statins for at least 15 years and it's partially designed to harden plaque at least as i understand it.

in sum, after reading all these books about heart healthy living, i've decided to eat right, exercise at least 4 x a week, and take a statin plus a PSK9 inhibitor. that's an injectable and they are remarkable in bringing down LDL cholesterol. Mine now is at 5 which I'm told is too low. This after taking Repatha (the PSK9 inhibitor) and 10 mg of statin for a year. Now I'm cutting back to 5 mg at doctor's orders. My overall cholesterol sank to 77!

I also swim 3x a week and walk most every day and lift weight once a week, mostly. i don't always have time for that. it's important but low on my list of priorities.

BTW, Repatha is very consumer friendly and likely you'll be able to get a $5 co pay coupon if you go on their website (PS I am not affiated with them in any way).

good luck, hope this helps .