Deregulation of fatty acid synthase(FASN) catalyzed de novo fatty acids biogenesis could play a central role in the pathogenesis of atherosclerosis.We reviewed pharmacological and genetic alterations of FASN activity that have been shown to significantly influence artherosclerosis and its risk factors including obesity,type 2 diabetes.First,the endogenous fatty acids which are catalyzed by the key enzyme FASN are one of atherosclerotic plaque compositions.Secondly,FASN influences the oxidized low density lipoprotein intake and cholesterol efflux in macrophage,which would absolutely affect the plaque formation.Thirdly,FASN plays a key role in monocytes differentiation.Inhibitting FASN may reduce the formation of foam cells.In addition,FASN involved in lipid metabolism is also associated with metabolic diseases,such as obesity and diabetes which are the risk factors for coronary heart disease.We propose that the development or the progression of artherosclerosis can be prevented or reversed by the modulation of FASN status.The use of FASN inhibitors might be a valuable therapeutic approach for coronary disease.