Background: Bempedoic acid, a potent inhibitor of ATP-citrate lyase, has emerged as a novel lipid-lowering agent that specifically targets cholesterol biosynthesis upstream of the statin pathway. Coronary artery diseasepatients often require intensive low-density lipoprotein cholesterol reduction, but many encounter barriers such as statin intolerance and suboptimal response. This study aimed to evaluate the efficacy and safety profile of bempedoic acid as an adjunct to statin therapy in patients with established coronary artery disease (CAD). Methods: A prospective, single-center study enrolled adult CAD patients on stable statin therapy (moderate- or high-intensity) who received adjunctive bempedoic acid (180 mg daily). Patients were followed for 12 months. Primary endpoints included changes in LDL-C levels and incidence of major adverse cardiovascular events. Secondary endpoints included changes in other lipid parameters and incidence of adverse events. Laboratory assessments and Clinical evaluations were conducted at baseline and subsequently at 3, 6, and 12 months. Results: A total of 200 patients (mean age 64.3 ± 9.2 years) were enrolled. Adjunctive bempedoic acid led to a significant reduction in LDL-C (mean 21.5% decrease from baseline, p<0.001) at 12 months. Improvements were also observed in total cholesterol and non-HDL cholesterol. The incidence of MACE (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or urgent revascularization) was 8.5%, which was lower than historical rates in similar high-risk populations. Adverse events included mild-to-moderate myalgias (6%), elevated liver enzymes (3%), and new-onset diabetes (2%). Serious adverse events were rare and did not differ significantly from those observed in statin-only groups. Conclusion: In CAD patients receiving stable statin therapy, adjunctive bempedoic acid was associated with additional LDL-C reduction and a favorable safety profile. These findings highlight the potential of bempedoic acid as an effective adjunct therapy for optimizing lipid management in high-risk patients with coronary artery disease (CAD).