Inflammatory Activity in Multiple Atherosclerotic Plaques of Patients Dying of Acute Myocardial Infarction

pp. 81-87

Abstract

Background

Data from clinical and histopathologic studies suggest that inflammation plays a key role in instability of atherosclerotic plaque as patients with acute coronary syndromes present diffuse inflammatory infiltrates in the coronary arteries.

Objectives

To assess and locate the distribution of vulnerable plaques and inflammatory infiltrates in patients who died of acute myocardial infarction.

Material and Methods

We examined the coronary arteries from 58 patients who died of myocardial infarction using light microscopy. The following variables were evaluated in culprit and non-culprit coronary arteries: presence of thrombus, plaque rupture, intraplaque hemorrhage and inflammatory infiltrate.

Results

The presence of thrombus and intraplaque hemorrhage was significantly greater in culprit coronary arteries compared to non-culprit vessels (69% versus 38%; p<0.008, and 69% versus 50%; p<0.03, respectively). There were no significant differences in the presence of inflammatory infiltrates in atherosclerotic plaques from culprit and non-culprit coronary arteries (77% versus 71%; p=ns).

Conclusion

Inflammatory activity was demonstrated in acute myocardial infarction affecting not only the infarct-related artery but also other coronary vessels. Plaque accident was also present in more than one coronary artery.