PCSK9 and endothelial dysfunction: Endothelial dysfunction is improved by inhibition of the Rho/ROCK (Rho-Kinase) pathway, leading to increased NO production, while antithrombotic properties such as atherosclerotic plaque stabilization are also attributed to this drug class.394 Evolocumab, an injectable lipid-lowering drug, apparently decreases arterial stiffness by inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9), thus minimizing oxidative stress and inflammation.395