In another study of patients with angiographically confirmed CAD, Ortiz-Perez et al. demonstrated elevated levels of circulating ACE2 at baseline (24-48h) in patients presenting with ST-elevation myocardial infarction compared to a control group of patients without known CAD.[24] It is not therefore clear from the Ortiz-Perez et al. study whether the increase in circulating ACE2 reflects acute cardiac injury or underlying atherosclerosis. This evidence concerns the gene ACE2 and atherosclerosis.