Remodeling of Coronary Arteries in Human and Nonhuman Primates

OBJECTIVE: To compare coronary artery remodeling (compensatory enlargement) in human and nonhuman primates. DESIGN: Coronary artery data were analyzed retrospectively for 416 nonhuman primates and 100 men and women. SETTING: The monkeys had been in experiments involving diet-induced coronary artery atherosclerosis. The human hearts were obtained from the North Carolina Baptist Hospital, Winston-Salem, and age greater than 25 years was the only criterion. PATIENTS AND OTHER PARTICIPANTS: The left anterior descending coronary arteries from 100 humans, 328 cynomolgus monkeys, and 88 male rhesus monkeys were used. INTERVENTIONS: None; this was a cross-sectional observational study. MAIN OUTCOME MEASURES: Coronary artery size, lumen area, and plaque size. In the humans, we also examined demographic characteristics (ethnicity, sex, and history of hypertension) and pathologic criteria (eccentricity or concentricity of plaque area). RESULTS: On average, lumen size remained unaffected by plaque size. Lumen size was variable and could not be predicted by traditional risk factors for coronary heart disease. However, lack of compensation (decreased lumen size as plaques enlarged) and history of coronary heart disease were significantly correlated. CONCLUSIONS: The similarity of remodeling in human and nonhuman primates suggests that the process has general biologic significance. Lack of remodelling may be a major determinant of whether a person with coronary artery atherosclerosis develops its complications.