SERPINE1, also known as PAI-1, plays an essential protective role in AAA rupture as a significant inhibitor of tissue plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) and plays the same role in sex differences (DiMusto et al., 2012; English et al., 2015). The gene discussed is SERPINE1; the disease is triple-A syndrome.