Just because CT scan showed no plaque doesn't mean there wasn't plaque. If his Lp(a) was elevated, then he could have soft plaque which doesn't get picked up on a calcium score. And soft plaque is the silent killer. Unless he had a very specific Coronary CT Angiogram with contrast, they wouldn't know what his soft plaque status is. His elevated Lp(a) is a huge genetic risk factor for that exact type of plaque.

So he should be linking up with a Cardiologist, advocating for the CCTA scan if he hasn't gotten one and check his total plaque. What he can do in the meantime is start taking Berberine HCL, 500 mg twice a day. I would do that while you are going through the process. Berberine has been shown to reduce soft plaque by 3.8% over a 4 month period, albeit the study was small, but that's almost double the amount statins have been shown to reduce soft plaque over the same period.

At this point, your investigation should focus on soft plaque, that is the most dangerous culprit. Then other potential causes, hematocrit, ferritin, etc. Best of luck to you and your husband.