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Association between complex coronary artery stenosis and unstable angina and the extent of plaque inflammation

Martijn Meuwissen1, Allard C van der Wal, Karel T Koch

  • 1Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.meuwissen@amc.uva.nl

The American Journal of Medicine
|May 20, 2003
PubMed

Insights

Inflammation in atherosclerotic plaque is linked to complex coronary lesions and unstable angina. This study found higher macrophage levels in complex lesions and unstable angina patients, indicating a strong association.

Area of Science:

  • Cardiology
  • Immunohistochemistry
  • Pathology

Background:

  • Unstable coronary syndromes often present with complex coronary stenoses.
  • Qualitative angiographic assessment is used to evaluate coronary lesions.
  • Plaque inflammation plays a role in the pathophysiology of atherosclerosis.

Purpose of the Study:

  • To evaluate the association between the qualitative assessment of coronary stenoses and plaque inflammation.
  • To determine if angiographic lesion complexity correlates with inflammatory markers in atherosclerotic plaques.
  • To investigate the relationship between unstable angina and the inflammatory status of coronary lesions.

Main Methods:

  • Seventy-nine patients with stable or unstable angina underwent directional coronary atherectomy.
  • Coronary lesions were classified as simple or complex based on angiographic morphology.
  • Immunohistochemistry was used to quantify macrophages (CD68) and T lymphocytes (CD3) in atherosclerotic specimens.

Main Results:

  • Higher percentages of macrophages were found in atherectomy specimens from patients with unstable angina compared to stable angina (21% vs. 13%, P=0.01).
  • Complex coronary lesions showed significantly higher macrophage infiltration than simple lesions (23% vs. 9%, P<0.001).
  • Multivariate analysis confirmed a strong association between unstable angina, lesion complexity, and increased plaque macrophages.

Conclusions:

  • Atherosclerotic plaque inflammation, indicated by macrophage content, is associated with angiographic lesion complexity.
  • Unstable angina is linked to a higher degree of plaque inflammation.
  • Angiographic assessment of lesion morphology provides insights into underlying plaque inflammation.
Abstract

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