Coronary atherothrombosis is a multifactorial disease dependent on environmental and genetic risk factors, not all of which have been identified. The renin-angiotensin system of the intermediary of the angiotensin I converting enzyme (ACE) plays a key role in cardiovascular physiopathology and contributes to phenomena of atherothrombosis. The concentrations of circulating ACE are partially determined genetically by the presence of polymorphism of insertion and deletion at the 16 intron of the gene. The implications of this polymorphism with respect to coronary disease have already been the object of many publications with contradictory results, usually in case-controlled studies. In this study, the authors sought to determine its influence on the morbi-mortality after myocardial infarction. A prospective cohort of 970 consecutive patients were followed-up for an average of 2.5 years. Genetic analysis was performed by a classical PCR protocol. The following independent predictive factors of mortality were the classical factors of age, hypercholesterolaemia and left ventricular dysfunction. However, the authors did not observe an effect of I/D polymorphism of the ACE gene on the occurrence of adverse cardiac events after myocardial infarction (death, infarction, revascularisation).