Relationship between coronary artery remodeling and plaque vulnerability

Area of Science:

• Cardiovascular Pathology
• Arterial Remodeling
• Atherosclerosis Research

Background:

• Complex plaque anatomy and rupture are linked to outward arterial remodeling.
• Lipid core size and macrophage infiltration are histological markers of plaque vulnerability.
• The relationship between these vulnerability markers and coronary artery remodeling was previously unexplored.

Purpose of the Study:

• To investigate the association between coronary artery plaque remodeling and histological markers of vulnerability.
• To determine if positive remodeling correlates with larger lipid cores and higher macrophage counts.

Main Methods:

• Studied 108 plaques from 88 male subjects with coronary artery disease.
• Categorized lesions as having positive remodeling (remodeling >= 0%) or negative remodeling (vessel shrinkage, remodeling < 0%).
• Assessed percent lipid core and macrophage count for each plaque.

Main Results:

• 59.2% of plaques exhibited no remodeling or positive remodeling; 40.7% showed negative remodeling.
• Plaques with positive remodeling had significantly larger lipid cores (39.0% vs 22.3%, P < 0.0001).
• Positive remodeling was associated with a higher macrophage count (15.6 vs 8.9, P = 0.005).

Conclusions:

• Coronary artery plaques with positive remodeling demonstrate increased lipid content and macrophage infiltration.
• These findings identify positive remodeling as a marker associated with plaque vulnerability.
• The results may explain plaque rupture at sites with modest luminal stenosis but significant positive remodeling.