Another possible mechanism could be via gene-environment interaction, where those at highest genetic risk of CM benefit more from treatment (e.g. immunotherapy), as it is the case for those at high genetic risk for coronary artery disease (CAD) and treatment benefits from PCSK9 inhibitors in the FOURIER and ODYSSEY OUTCOMES trials [58, 59]. The gene discussed is PCSK9; the disease is coronary artery disorder.