Considering that subjects with metabolic diseases show a higher incidence of cardiovascular diseases, increased circulating PAI-1 levels might be a causative link between metabolic syndrome and atherothrombotic diseases, and therefore, the inhibitory effect of sarpogrelate on circulating PAI-1 may imply additional benefits of sarpogrelate for the protection of CKD-induced cardiovascular complications. This evidence concerns the gene SERPINE1 and chronic kidney disease.