Elevated PAI-1 levels are, in fact, a significant causative factor in the pathophysiology of diabetes, vascular thrombosis, metabolic syndrome, septic coagulopathy, atherosclerosis, restenosis and myocardial infarction, particularly in the context of increased tissue TGF-β1 levels [1-4]. The gene discussed is SERPINE1; the disease is myocardial infarction.