Chemotherapy agents might influence VEGF effects directly, as is the case for VEGF inhibitors (VEGFIs), or as a secondary effect as occurs with the ‘classical’ cytotoxic drugs, including antimetabolites, taxanes, anthracyclines, and alkylating agents.5, 13, 14 Interruption of VEGF signalling is associated with the development of vascular toxicity and clinical sequelae such as hypertension, acute coronary syndromes, stroke, venous thrombosis, and thromboembolism.5, 15, 16, 17, 18. The gene discussed is VEGFA; the disease is acute coronary syndrome.