PCSK9 and familial hypercholesterolemia: In the latest American College of Cardiology/American Heart Association (ACC/AHA) guidelines, PCSK9 inhibitors are recommended in high-risk secondary prevention patients who are on maximally tolerated statin therapy but have LDL-C greater than 70 mg/dL, and in patients with severe primary hypercholesterolemia (LDL-C > 190 mg/dL) or heterozygous Familial Hypercholesterolemia (FH) who are not at the goal despite maximally tolerated therapy [19].