Previous and recent findings support the idea that characterization of emerging biomarkers of impaired fibrinolysis such as PAI-1 should be measured for surveillance of transition from a healthy state through the development of the Metabolic Syndrome to atherothrombotic disease and for prevention purposes in individuals with high risk of atherothrombotic disease in order to help us identify vulnerable groups for the correct targeting treatments and avoid future atherothrombotic complications such as myocardial infarction and stroke. The gene discussed is SERPINE1; the disease is myocardial infarction.