I'm 62 and my father died at 55 (as well as grandfather, aunt, and uncle all in the 40's and 50's, plus 3 cousins with heart attacks and/or stents also at young ages). I'm asymptomatic and also have had a good stress test. I have maintained my ldl in the 50-70 range for years with 20mg Crestor and 10mg Zetia. After my high cac score (1014) my cardiologist call the very next day and was very alarmist due to the risk associated with the high cac (25% chance of a major CV event within a year, likely one within 3-5 years).. He immediately increased my statin to 40. Within a month my liver enzymes increased to 5-6 times the mormal upper limits, whereas in the past they never were outside normal limits. I then had to stop the statin completely for a month which got my AST back to normal and my ALT to 1.5 times normal (he said it's OK as long as it is not more than 2.5 times normal). I'm now back to 20mg and am being monitored every sis months.
As long as you are asymptomatic and living a healthy life style there is not much else you can do. As soon as you experience symptoms make sure you call your doctor or get to a hospital. Knowing you have a high cac score is a double edged sword. It is good to know you are at high risk so you can manage the risk factors that are within your control. However, that same knowledge can create stress and anxiety with the uncertainty of if/when you may have an event. If the latter is a major issue make sure you reach out and address it to avoid sure it doesn't lead to situational depression. You have to live your life as normally as possible!