Complicating this issue, while atherosclerosis in the aorta of PAI-1−/−/ApoE−/− and PAI-1+/+/ApoE−/− were similar, there was a decrease in disease progression at the carotid bifurcation in PAI-1−/−/ApoE−/− suggesting PAI-1 may potentiate lesion development at sites of turbulent flow [45]. This evidence concerns the gene SERPINE1 and atherosclerosis.