Third, circulating PCSK9 enhances platelet activation and that PCSK9 inhibitors reduce it, and one of the underlying mechanisms is that the treatment of PCSK9 inhibitors reduces platelet activation modulating soluble-NOX2-derived peptide activity and in turn oxidized-LDL formation in patients with heterozygous familial hypercholesterolemia.[31]. This evidence concerns the gene PCSK9 and familial hypercholesterolemia.