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Epigenetic Modification in Coronary Atherosclerosis: JACC Review Topic of the Week. Coronary artery disease (CAD) and its major complication, acute myocardial infarction (AMI), are the leading causes of disability and death worldwide. An individual's risk of developing CAD and MI is modulated by an interplay between genetic and lifestyle factors. It is now clear that epigenetics may play a central role in the development of CAD because epigenetic patterns are affected by the environment and can modulate gene expression. Here, the authors discuss the major epigenetic changes that contribute to CAD and the latest discoveries on the influence of the environment on epigenetic profiles in the development of CAD.