To the best of our knowledge, this is the first report that ALDH2 can directly influence plaque development, stability and inflammation through MAPK, NF-κB and AP-1 signaling pathways, which suggests an important explanation for ALDH2 functioning as a CAD or ACS susceptibility gene and supplies solid evidence for ALDH2 effects on vasculature. This evidence concerns the gene ALDH2 and coronary artery disorder.