In addition, soluble PCSK9, LDL-C, and proinflammatory factors were analyzed in 1190 patients with acute coronary syndrome (ACS).<h4>Results</h4>Alirocumab reduced plaque lesion (0.42-fold; <i>p</i> < 0.05) and lipid (0.63-fold; <i>p</i> < 0.01) and macrophage (0.61-fold; <i>p</i> < 0.05) infiltration, mainly the M1 subtype (0.37-fold; <i>p</i> < 0.01), as well as TLR4, NLRP3 and caspase-1 expressions (0.49-fold, 0.51-fold and 0.51-fold, respectively; <i>p</i> < 0.05), without altering LDL-C. This evidence concerns the gene TLR4 and acute coronary syndrome.