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ST elevation myocardial infarction (STEMI) have good long-term prognosis compared to Non-STEMI (NSTEMI). Intraplaque hemorrhage (IPH), frequently observed in vulnerable plaque, accelerates atherosclerosis through cholesterol-enriched erythrocyte membranes load and prooxidant stress of hemoglobin (Hb). Plaque Hb is cleared by macrophages with scavenger receptor CD163. These macrophages can counteract atherogenicity of IPH by secreting anti-atherosclerotic interleukin (IL)-10. IPH, macrophage phenotype, and IL-10 production within plaques were compaired.
In 24 (13 STEMI and 11 NSTEMI) patients, intravascular ultrasound (IVUS) was performed after thrombus aspiration. During primary percutaneous coronary intervention, atherothrombotic debris was retrieved using filter-based distal protection device (Filtrap). The debris were stained with antibodies to glycophorin A (GPA, intraplaque hemorrhage), CD14 (proinflammatory macrophage), CD163 (Hb scavenging macrophage) and IL-10.
Compared to NSTEMI, STEMI showed large lumen area and increased remodeling index, indicating abrupt vessel closure and vessel enlargement. GPA and CD14 were increased in STEMI. Anti-atherosclerotic CD163 and IL10 were also increased in STEMI. (Table).
Intraplaque hemorrhage and vessel inflammation have association with STEMI. Increased anti-atherosclerotic macrophage and IL-10 in STEMI might explain better long-term prognosis compared to NSTEMI.
|Lumen (mm2)||Remodeling Index||GPA(/cm2)||CD14 (%)||CD163 (%)||IL10 (%)|
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes: Role of Inflammation
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1258-203
- 2013 American College of Cardiology Foundation