This process of fibrosis and scarring is precisley what we have observed in the endothelial vasculature and smooth muscle in the affected coronary artieries in the CAD plus T2DM patients in the present study Fig 2, panel I. MACF1 (Microtubule actin cross-linking factor 1) appears to be an important pleiotropic factor involved in and at the cross-roads of metabolic syndrome, inflammation, T2DM, and CVD [41]. The gene discussed is MACF1; the disease is metabolic syndrome.