PCSK9 and metabolic syndrome: In agreement with the 2019 ESC/EAS guidelines for the management of dyslipidemias and the national PCSK9-i prescriptive regulation (Mach et al., 2020; Pasta et al., 2020), PCSK9-i treatment was started in all FH subjects; specifically, six subjects added alirocumab 150 mg and 25 subjects added evolocumab 140 mg, every 2 weeks.