Statins do not decrease plasma Lp(a) levels.29) Studies have demonstrated that proprotein convertase subtilisin/kexin type 9 inhibitors decrease serum Lp(a) and LDL-C levels and significantly decrease the risk of cardiovascular event or major adverse limb events.30) Thus, plasma Lp(a) levels may be a causal residual risk factor correlated with long-term survival, cardiovascular events, and fate of the limb in patients with PAD. This evidence concerns the gene PCSK9 and peripheral arterial disease.