Although most studies investigated the effects of PCSK9 on LDL-C metabolism, an increasing number of experimental and clinical studies have demonstrated that PCSK9 contributed directly to the progression of atherosclerosis by enhancing the expression of pro-inflammatory genes, promoting apoptotic cell death and leading to endothelial dysfunction independent of its effect on the LDLR [7, 8]. The gene discussed is PCSK9; the disease is endothelial dysfunction.