Beyond oncology, TIMP1 was elevated in atherosclerosis, aligning with immune- and lipid-related pathways, but reduced in heart failure, where it was linked to impaired mitochondrial metabolism.<h4>Conclusion</h4>This multi-level and bioinformatics study identifies TIMP1 as a cross-disease regulator with context-dependent functions. This evidence concerns the gene TIMP1 and atherosclerosis.