Coronary artery disease (CAD) and its main complication myocardial infarction are the leading causes of death globally. Environmental factors don't explain the large amount of variance seen in the development of the disease. Given the strong heritability of CAD, some of the unexplained variance may be due to genetic factors. In this issue of the Journal, Jiang and colleagues report a strong association between brain derived neurotrophic factor (BDNF) Val66Met polymorphism and CAD. There is increasing evidence that BDNF is not only involved in neuronal development but also energy expenditure. The results of this study are likely to give further impetus to researching the complex mechanisms and crosstalk that contribute to the pathogenesis of various polygenic disorders.