Background: Coronary artery disease (CAD) remains a leading cause of mortality and disability globally, and percutaneous coronary intervention (PCI) is a key revascularization procedure. However, patients often face residual risks, including dyslipidemia and persistent inflammation post-PCI. This meta-analysis aimed to systematically evaluate the effects of Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on lipid profiles and inflammatory biomarkers in CAD patients after PCI.

Methods: We conducted a systematic literature search of PubMed, Web of Science, and Embase databases, with a cutoff date of September 2025. Only randomized controlled trials (RCTs) were included in the analysis. The methodological quality in the selected studies was assessed using the Cochrane Risk of Bias tool, and the meta-analysis was performed using RevMan software. For continuous outcome, results were expressed as the mean difference (MD) with a 95% confidence interval (CI). Fixed-effect or random-effects models were selected for analysis based on the degree of heterogeneity, as quantified by the I² statistic.

Results: A total of 8 RCTs involving 1043 participants were included. The overall quality of evidence was moderate. PCSK9 inhibitors significantly reduced levels of triglycerides (MD = –0.52, 95% CI: –0.92– –0.12; I² = 76%), total cholesterol (MD = –0.61, 95% CI: –0.91– –0.32; I² = 66%), and low-density lipoprotein cholesterol (LDL-C) (MD = –1.37, 95% CI: –2.24– –0.50; I² = 99%). Regarding inflammatory biomarkers, tumor necrosis factor-α (TNF-α) was significantly reduced (MD = –23.65, 95% CI: –28.68– –18.62; I² = 67%), while no statistically significant differences were found for high-sensitivity C-reactive protein (hs-CRP) (MD = –1.49, 95% CI: –3.44– 0.46; I² = 97%) or interleukin-6 (IL-6) (MD = –6.84, 95% CI: –15.15–1.46; I² = 98%).

Conclusion: PCSK9 inhibitors significantly improve lipid parameters and certain inflammatory markers in CAD patients after PCI, suggesting benefits beyond lipid-lowering. Further high-quality trials are needed to confirm these findings and evaluate clinical outcomes.