SDC4 mediates a variety of biological processes, including cell migration, proliferation, adhesion, endocytosis, tissue repair and regeneration, cell–matrix interactions, and matrix remodeling.[8–11] Several studies have shown that stress factors, such as ischemia, hypoxia, and infection, can trigger the expression of SDC4 receptors.[12,13] It is well known that macrophage-mediated vascular inflammatory responses play a crucial role in the formation of atherosclerosis.[14–16] Yet, the role of SDC4 in macrophage-mediated atherogenesis in AS patients remains unclear. Here, SDC4 is linked to atherosclerosis.