Recent large outcome trials have consistently demonstrated that PCSK9 mAbs (evolocumab and alirocumab) markedly reduce LDL and improve ASCVD outcomes in high risk patients (with diabetes, metabolic syndrome, chronic kidney disease, peripheral arterial disease, and multiple large artery disease) on statin therapy (Sabatine et al., 2017; Schwartz et al., 2018; Ray et al., 2019; Deedwania et al., 2020). The gene discussed is PCSK9; the disease is metabolic syndrome.