Negative remodelling is found in stenotic CAD, however positive remodelling is seen in CAE.12 In a study by Yolcu and colleagues, it was shown that serum levels of plasminogen activator inhibitor-1, which causes an increase in activity of matrix metalloproteinase, increased in patients with isolated ectasia, suggesting different pathways other than atherosclerosis in ectasia formation.12 Here, SERPINE1 is linked to atherosclerosis.