PCSK 9 Inhibitor Added to High-Intensity Statin Therapy to Prevent Cardiovascular Events in Patients With ACS After PCI

This study tests whether adding a PCSK9 inhibitor (a powerful cholesterol-lowering drug) on top of high-intensity statin therapy can further reduce cardiovascular events (like heart attacks and strokes) in patients who recently had a heart attack or severe chest pain (acute coronary syndrome, ACS) and also have non-culprit coronary artery disease. You may be eligible if: - You are 18 or older and had an ACS (unstable angina, NSTEMI, or STEMI) and received a coronary stent (PCI) - Your LDL cholesterol is still elevated despite statin therapy (specific thresholds based on your current statin regimen) - You have at least one significant non-culprit vessel blockage - You are willing to participate and attend all required visits You may NOT be eligible if: - Your triglycerides are above 400 mg/dL - Your coronary disease is in a bypass graft - Your stent procedure did not fully open the blocked artery - You are in cardiogenic shock or have hemodynamic instability - You have severely uncontrolled high blood pressure - You have severe heart failure (NYHA Class III–IV) or low ejection fraction (under 30%) - You had a hemorrhagic stroke in the past 180 days - You have severe kidney dysfunction (eGFR below 30) - You have active liver disease or statin intolerance - You have previously received a PCSK9 inhibitor - You are a woman of childbearing potential not using reliable contraception - You have a history of cancer within the past 5 years Talk to your doctor to see if this trial is right for you.