The International guidelines for the prevention of atherosclerotic cardiovascular disease (ASCVD) recommend the use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (PCSK9i) in high-risk patients as second-line lipid-lowering agents in addition to the maximally tolerated statin dose [1]. This evidence concerns the gene PCSK9 and atherosclerosis.