BMAL2 forms a complex with CLOCK, and binds to the E-box elements upstream of the pai-1 gene to activate the PAI-1 promoter and induce PAI-1 mRNA expression.50 Thus BMAL2 regulates the circadian oscillation of PAI-1 gene expression in endothelial cells.50 Increased expression of PAI-1 activity is associated with an increased risk of acute myocardial infarction.51 PAI-1 promoter activity is inhibited by fundamental components of the central clock, including per1, 2 and cry1, 2.49 This evidence concerns the gene SERPINE1 and acute myocardial infarction.