A 52-year-old man from Delhi presents with xanthomas on his Achilles tendons and eyelids. Serum total cholesterol is 580 mg/dL, LDL-C is 450 mg/dL, and triglycerides are 150 mg/dL. Genetic testing confirms heterozygous familial hypercholesterolemia (FH) with a defective LDL receptor gene. He is currently on atorvastatin 40 mg daily but remains at very high cardiovascular risk. What is the most appropriate next step in management?