A localized oxygen deficit is a common factor in macrophage-rich areas of advancing human carotid atherosclerotic lesions [210] and since CAD macrophages displayed increased expressions of dimerized PKM2, a similar mechanism of synergistic action between PKM2 dimers and HiF-α in triggering PD-L1 on hyperinflammatory macrophages and on inflamed vascular endothelial cells in atherosclerostic blood vessel diseases are expected. The gene discussed is PKM; the disease is coronary artery disorder.