Wong ND, Bang M, Block RC, et al. - Current guidelines suggest add-on proprotein subtilisin/kexin type 9 inhibitor (PCSK9i) treatment for additional LDL-C lowering beyond statins in heterozygous familial hypercholesterolemia (HeFH), but treatment patterns and barriers associated with PCSK9i in HeFH patients are required to be further explored, and therefore, researchers herein analyzed physician attitudes, use, as well as barriers for treatment in patients with HeFH. A total of 1,000 physicians (500 primary care providers [PCPs] and 500 cardiologists in the US were surveyed. More chances of not only ranking a PCSK9i as most important for an HeFH patient requiring additional LDL-C lowering, but also prescribing and having a patient on a PCSK9i, were observed among cardiologists when compared with PCPs. Probability of actually prescribing a PCSK9i was less among PCPs vs cardiologists, was more in private vs academic practice, and was more also among those who would prescribe a PCSK9i in an HeFH patient with or without atherosclerotic cardiovascular disease requiring additional LDL-C decrease beyond a statin. Overall, the gaps in understanding and treatment regarding PCSK9is can be addressed by ensuring greater physician education as well as assistance among both cardiologists and PCPs.