No significant differences in lipid profiles, Lp(a), ANGPTL3, and PCSK9 levels were evidenced between men diagnosed with localized high‐grade Gleason 8 or 9 prostate cancer (PCa) compared to men at risk for PCa who remained cancer‐free for at least 3.2 years following a negative biopsy. Here, PCSK9 is linked to posterior cortical atrophy.