Accepting hemostatic system protagonism in atherosclerosis and coronary artery disease evolution implies a new look over pathogenic hypothesis and the reassessment of epidemiological based evidences. Prothrombotic states emerge as an expanding intervention field where the screening of hemostatic factors deficiencies is powered by the studies of the activation markers of plasmatic or cellular partners. While waiting for a reasonable synthesis attempt, we can trty the study of genomic polymorphisms in search of a new approach of conventional risk factors management.