Cao YX, et al. - Researchers examined the link between lipoprotein (a) (Lp[a]) or proprotein convertase substilisin/kexin type 9 (PCSK9) and atherosclerotic lesions of different artery sites (coronary artery disease [CAD] and peripheral artery disease [PAD]) in patients with familial hypercholesterolemia (FH). Among a total of 151 included patients with verified genotyped heterozygous FH (HeFH), 151 patients had available data regarding coronary angiography and carotid ultrasonography and 55 patients had data regarding femoral ultrasonography. PCSK9 levels were significantly increased in patients with coronary and carotid atherosclerotic lesions vs non-atherosclerotic groups, while no difference was found in femoral atherosclerotic lesions groups. The highest prevalence and severity of atherosclerotic lesions were found in patients with the highest PCSK9 and Lp(a) concentrations. Findings also demonstrated that Lp(a) was identified as only a marker for CAD in HeFH patients, but circulating PCSK9 concentrations was associated with an increased risk of CAD and PAD.