PCSK9 and metabolic syndrome: As recommended in the guidelines for the management of dyslipidemias by the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS), treatment with a PCSK9 inhibitor is indicated for secondary prevention to reduce plasma LDL-C in very-high risk patients who do not achieve their target LDL-C or even for primary prevention in particular very-high risk patients as those with familial hypercholesterolemia (FH) who do not achieve their LDL-C goal despite maximal tolerated therapy with statins and ezetimibe [4].