Determines eligibility for PCSK9 inhibitor therapy (evolocumab, alirocumab). Indicated for very high-risk patients with clinical ASCVD and LDL-C ≥70 mg/dL on maximally tolerated statin therapy (with or without ezetimibe). Also indicated for heterozygous or homozygous familial hypercholesterolemia. PCSK9 inhibitors reduce LDL-C by 50–65% and reduce MACE by 15–20%.
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