Out there would do what they stated, half would proceed with a stress test.
If the stress test was abnormal it would go to a cath. But that pathway isn’t as clear cut and more controversial. The guidelines aren’t super helpful here.
Otherwise I would get your ldl <55, apoB less than 80 (or even 60) with a repeat lipids test in 3 months. Then make get your fitness levels or vo2 max up as high as possible. Control other risk factors.
But I totally get how that sucks to have hanging over your head