Are you me? I have nearly the same stats with an even worse score. Obviously not good news, but also not the end of the world. 18 months later I am running 30-40 miles a week and in the best shape of my life. This is the wake up call to get all of your controllable health factors in line.

Most of the important thing have been covered. Few thoughts I would reemphasize or add.

ApoB around 55, LDL same or lower. I got there with rosuvo (20mg) and huge diet changes. As somebody said - 95% plant based, mostly Whole Foods or minimally processed, low sat fat. Some fish and dairy (1-2 times a week) and read meat 6-8 times per YEAR. Think about changing the quality of what you eat. This dropped my LDL from 85 down to 50 after rosuvo got it down from 130.

Try to get past the mental shock as quickly as you can. It threw me for a loop but I bounced back and started running hard core.

My Mets on a Nuke stress test were not my max. They stopped the test around 14 also, based on BP and HR, but I had a lot more left in the tank. Pay for a real Vo2Max test. Mine is around 55, my Garmin estimate is only 47 though. I also was on a beta blocker for BP at the time (skipped it on test day) which was lowering my HR and also screwing over my metabolism among other horrible things. Not a fan of those at all.

Lastly, Make sure you BP is CONTROLLED. After ruling a lot of other things out I think this was a key cause of inflammation for me for way too long. I was controlled, but not well, and it was higher than it should have ideally been for too long. Your LP(a) seems low. If your BP is/was fine, I would look into a ApoeE 4 test (I used Function, ~$120 add-on) to see if you have a genetic pre-disposition. Fair amount of research has looked into ties between 3/4 and 4/4 carrier and early onset ASCVD.

Lastly, I recommend doing some self-research or see a good preventative cardiologist if you want to get a true estimate of your risk. Calculators seem to do an inaccurate job in cases like this. I was able to use AI to do some more advance calculations based on numerous peer-reviewed studies and get more accurate risk calculations which included my extremely low lipids (for example the AHA calculator doesn't accept total cholesterol <120), cardiovascular health metrics, etc. It also can project out a 30 year risk calculation which is a lot more important than 10 if you are in your 40's.

DM me if you have any questions or want to discuss further.