This commentary refers to 'Plasma proteome and incident myocardial infarction: sex-specific differences', by O.E. Titova et al., https://doi.org/10.1093/eurheartj/ehae658 and the discussion piece 'Gender-specific associations and circulating proteins in myocardial infarction: potential causal relationships', by Y. Xu et al., https://doi.org/10.1093/eurheartj/ehaf111