Dalgic Y, Abaci O, Kocas C, et al. - Among patients with non-ST-elevation myocardial infarction (NSTEMI) who underwent coronary angiography, researchers examined the link between protein convertase subtilisin kexin type-9 (PCSK9) levels and the severity of coronary artery disease, given PCSK9 was identified as a new risk factor for stable coronary artery disease in several studies. They prospectively enrolled a total of 168 patients with NSTEMI. They used SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX), Gensini and Jeopardy scores to assess the severity of atherosclerotic lesions. They found a strong positive correlation between PCSK9 and the three scores in the Pearson correlation analysis. With sensitivity and a specificity of 81% and 63%, respectively, a mid-high SYNTAX score of at least 25 was predicted when the PCSK9 level was higher than 52.8 ng/ml (area under a curve 0.76), in ROC analysis. Independent predictors of a high SYNTAX score as revealed in the multivariate linear regression analysis were PCSK9, low-density lipoprotein cholesterol and creatinine levels. Overall, experts concluded that risk for adverse events in patients with NSTEMI may be conferred by high PCSK9 levels, and this group of patients may derive benefit from aggressive lipid-lowering therapies.