Abstract: Provided are compositions that include compositions of galactosyl-conjugated lipid nanoparticles (LNPs) encapsulating one or more active agents. In some embodiments, the galactosyl-conjugated LNPs have a lipid component having D-Lin-MC3-DMA, ALC-0315 and SM-102, cholesterol. DSPC and DOPE, and DMG-2000-PEG. In some embodiments, the GalNAc-conjugated LNP has one or more galactosyl moieties bioconjugated to cholesterol present with a lipid component of the GalNAc-conjugated LNP. Also provided are methods for treating and/or preventing diseases, disorders, and/or conditions associated with undesirable PCSK9 gene expression, optionally a cardiovascular disease, disorder, or condition, including but not limited to atherosclerosis and/or thrombosis, and sepsis, septic shock, cytokine storm, or sequelae thereof.