PCSK9 and familial hypercholesterolemia: Preclinical studies have demonstrated that PCSK9 directly enhances platelet activation and in vivo thrombosis.[36,30] Accordingly, Cammisotto et al[37] found reduced platelet activation in patients with familial hypercholesterolemia after PCSK9 inhibitors administration, which was mechanistically linked to modulation of ox-LDL pathways.