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However, identifying responders to PCSK9 inhibitors remains unclear. This study investigates the characteristics of patients who achieve target LDL-C reduction (&lt;\u200970\u00a0mg\/dl) after PCSK9 inhibitor therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A multicenter, retrospective cohort study included patients initiating PCSK9 inhibitors at 11 teaching hospitals in Taiwan (2017\u20132021). Baseline characteristics, lipid-lowering therapies, and lipid profile changes were analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Among 211 patients (mean age 57.2\u2009\u00b1\u200913.1\u00a0years, 72.0% male), 73.5% used alirocumab and 26.5% used evolocumab. More than half had coronary artery disease and\/or hypertension. Of these, 120 patients achieved the LDL-C target. Target achievers had a lower baseline BMI (25.8\u2009\u00b1\u20093.7 vs. 27.4\u2009\u00b1\u20094.5\u00a0kg\/m<jats:sup>2<\/jats:sup>, P\u2009=\u20090.028) and a higher incidence of myocardial infarction and anti-platelet use compared to non-achievers. Baseline cholesterol and LDL-C levels were similar, but target achievers experienced greater LDL-C reductions (\u2212\u00a071.5; IQR \u2212\u00a081.8, \u2212\u00a062.2 vs. \u2212\u00a029.4; IQR \u2212\u00a038, \u2212\u00a010.5\u00a0mg\/dl, P\u2009&lt;\u20090.001), as well as decreases in triglycerides and increases in HDL-C. Glucose levels and liver enzymes did not differ significantly. Logistic regression revealed BMI as the only independent predictor of LDL-C target achievement (odds ratio: 0.899, 95% CI 0.821\u20130.984, P\u2009=\u20090.021).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Lower BMI at baseline was associated with a higher likelihood of achieving LDL-C\u2009&lt;\u200970 mg\/dl after 12 weeks of PCSK9 inhibitor therapy. These findings support personalized strategies for optimizing cholesterol management in statin-intolerant patients while further investigations are required.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s40001-025-02431-8","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T07:02:01Z","timestamp":1742022121000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lower body mass index is associated with the achievement of target LDL in patients using PCSK9 inhibitors in Taiwan"],"prefix":"10.1186","volume":"30","author":[{"given":"Kuan-Chieh","family":"Tu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Ting","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Wen","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Lin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Wen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Feng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-I.","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Ji","family":"Charng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Hsun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsien","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Wen","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.-Chang","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng-Yu","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Pei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Hsiang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Heng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,15]]},"reference":[{"issue":"11","key":"2431_CR1","doi-asserted-by":"publisher","first-page":"e563","DOI":"10.1161\/cir.0000000000000677","volume":"140","author":"DK Arnett","year":"2019","unstructured":"Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC\/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines. 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