The PI∗Z gene of the alpha-1-proteinase inhibitor was significantly more frequent in patients with coronary atherosclerosis than in long-lived survivors, and the local as well as systemic inactivation of the alpha-1-proteinase inhibitor in the atherosclerotic process could be related to hyperlipidemia: congenital (alpha-1-proteinase inhibitor deficiency, hyperlipidemia) and acquired (related to smoking, chronic inflammatory diseases, aging) imbalance of the proteinase-antiproteinase system is considered to be one of the atherogenic factors [3]. The gene discussed is SERPINA1; the disease is coronary atherosclerosis.