In HASMCs, calcification elevated PCSK9 levels (<i>p</i> < 0.001), calcification-related proteins (<i>p</i> < 0.05), and FGF23 expression (<i>p</i> < 0.001), whereas siRNA reversed these changes (<i>p</i> < 0.001, <i>p</i> < 0.01, <i>p</i> < 0.05, respectively).<h4>Conclusions</h4>Inhibition of PCSK9 may effectively slow the progression of coronary artery calcification, with inflammatory mediators such as FGF23 playing key regulatory roles in this process. The gene discussed is PCSK9; the disease is coronary artery calcification.