In addition to NF-κB activation and induction of pro-inflammatory cytokines, including TNF-α, IL-1β, and IL-6, PCSK9 directly induced the expression of adhesion molecules such as VLA-4 on monocytes, as well as VCAM-1 and ICAM-1 on ECs, leading to the enhanced interaction of these two cell types, which guides the initial steps in atherosclerosis development. This evidence concerns the gene ICAM1 and atherosclerosis.