Very Early PCSK9 Inhibition for Acute Myocardial Infarction

Inclusion Criteria 1. Age ≥18 years. 2. Acute myocardial infarction (AMI) onset within 30 days (first hospitalization with a confirmed diagnosis of STEMI or NSTEMI). 3. Multivessel coronary artery disease; successful percutaneous coronary intervention (PCI) of the culprit lesion in the infarct-related artery (IRA), including stent implantation and/or balloon angioplasty and/or thrombus aspiration. 4. At least one angiographically assessed diameter stenosis ≥50% in a non-infarct-related artery (non-IRA) with a reference vessel diameter ≥2.5 mm. 5. Able to understand and willing to provide written informed consent, comply with prescribed medical therapy, and complete the required follow-up. Exclusion Criteria 1. Cardiogenic shock or severe heart failure (Killip class IV). 2. Serum creatinine \>150 μmol/L or glomerular filtration rate (GFR) \<45 mL/min/1.73 m² calculated by the Cockcroft-Gault equation. 3. Known or suspected infective endocarditis or active systemic infection. 4. Clinically significant coagulation abnormalities, or anticipated inability to tolerate long-term antiplatelet therapy. 5. Pregnant or breastfeeding women, women planning pregnancy within 1 year, or those unwilling to use effective contraception. 6. Expected survival \<1 year. 7. Allergy to iodinated contrast media. 8. Prior coronary artery bypass grafting (CABG). 9. Participation in another clinical trial within 3 months before enrollment, or current participation in another drug/device clinical trial without having reached its primary endpoint. 10. Coronary angiography-based exclusion criteria: 10.1 Non-IRA lesion with visually estimated diameter stenosis \>90% and TIMI flow ≤2; 10.2 Complex coronary artery disease requiring CABG; 10.3 Angiography unable to clearly identify the infarct-related artery or non-infarct-related arteries.