Key result
Unstable angina pectoris was associated with significantly higher intraplaque haemorrhage, lipid peroxidation, and CD163 expression compared to stable angina (all P<0.0005).
Why the study?
Effective clearance of extracellular haemoglobin is thought to limit oxidative heme toxicity contributing to plaque instability, but its relationship with intraplaque haemorrhage and lipid peroxidation in human plaques was unclear.
Are intraplaque haemorrhage, lipid peroxidation, and haemoglobin scavenger receptor expression increased in culprit lesions of unstable angina compared to stable angina?
Observational (n=74)
Are intraplaque haemorrhage, lipid peroxidation, and haemoglobin scavenger receptor expression increased in culprit lesions of unstable angina compared to stable angina?
Intraplaque haemorrhage, lipid peroxidation, and haemoglobin scavenger receptor expression are significantly elevated in unstable plaques of patients with acute coronary syndromes.
Suggests intraplaque haemorrhage marks unstable angina lesions; leaves open whether targeting CD163+ macrophages improves outcomes.
AIMS: Effective clearance of extracellular haemoglobin (Hb) is thought to limit systemic oxidative heme toxicity, which is presumed to contribute to the pathogenesis of plaque instability. We immunohistochemically examined the relationship between intraplaque haemorrhage, 4-HNE (4-hydroxy-2-nonenal), an index of lipid peroxidation, and the Hb scavenger receptor (CD163), using coronary atherectomy specimens from 74 patients with stable angina pectoris (SAP, n = 39) or unstable angina pectoris (UAP, n = 35). METHODS AND RESULTS: Atherectomy samples were stained with antibodies against glycophorin A (a protein specific to erythrocyte membranes), CD31, 4-HNE, and CD163. Quantitative analysis demonstrated that glycophorin A-positive areas, 4-HNE-positive macrophage score, and CD163-positive macrophage score in UAP patients were significantly higher (glycophorin A, P < 0.0001; 4-HNE-positive macrophage score, P < 0.0001; CD163-positive macrophage score, P < 0.0005) than in SAP patients. The percentage of the glycophorin A-positive area showed a significant positive correlation with the number of CD31-positive microvessels and the 4-HNE-positive macrophage score (microvessels, R = 0.59, P < 0.0001; 4-HNE, R = 0.59, P < 0.0001). Moreover, the CD163-positive macrophage score was positively correlated with glycophorin A-positive area and the 4-HNE-positive macrophage score (glycophorin A, R = 0.58, P < 0.0001; 4-HNE, R = 0.53, P < 0.0001). CONCLUSION: These findings suggest a positive association among intraplaque haemorrhage, enhanced expression of Hb scavenger receptor, and lipid peroxidation in human unstable plaques.
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Yunoki et al. (2009) conducted an observational in Stable angina pectoris (SAP) or unstable angina pectoris (UAP) (n=74). Unstable angina pectoris (UAP) vs. Stable angina pectoris (SAP) was evaluated on Glycophorin A-positive areas, 4-HNE-positive macrophage score, and CD163-positive macrophage score (p=<0.0005). Unstable angina pectoris was associated with significantly higher intraplaque haemorrhage, lipid peroxidation, and CD163 expression compared to stable angina (all P<0.0005).
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