It was shown that the association between PCSK9 levels and a higher necrotic core fraction (as assessed by IVUS-VH) was linear, regardless of serum LDLc, in patients who underwent diagnostic coronary angiography or percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) or stable angina pectoris [51].Furthermore, a significant association between serum PCSK9 levels and intima-media thickening was observed in 126 hypertensive patients, persisting even after adjustment for blood lipids [52]. This evidence concerns the gene PCSK9 and acute coronary syndrome.