Multicentric inflammation in epicardial coronary arteries of patients dying of acute myocardial infarction

J Am Coll Cardiol. 2002 Nov 6;40(9):1579-88. doi: 10.1016/s0735-1097(02)02376-8.


Objectives: We sought to test the hypothesis of whether inflammatory cell infiltration in patients dying of an acute myocardial infarction (MI) is a multifocal event involving multiple coronary branches.

Background: Coronary instability is thought to reflect local disruption of a single vulnerable plaque. However, previous postmortem studies have not addressed the question of whether activation of inflammatory cells, particularly T lymphocytes, is limited to the culprit lesion only or rather diffuse in the coronary circulation.

Methods: We performed a systematic flow cytometric study in three groups of autopsied patients (group 1 = acute MI; group 2 = old MI; group 3 = no ischemic heart disease). Cell suspensions of enzymatically digested coronary arteries were stained for flow cytometry with CD3, CD68, alpha-smooth muscle actin, and human leukocyte antigen (HLA)-DR antibodies.

Results: The coronary plaques showed: 1) a higher proportion of inflammatory cells in groups 1 and 2 than in group 3; 2) a higher percentage of T lymphocytes in group 1 than in group 2 (11.67 +/- 0.70% vs. 5.67 +/- 0.74%, p = 0.001) and in group 2 than in group 3 (p = 0.008); and 3) diffuse cell activation in the whole coronary tree of group 1, but not of group 2 subjects.

Conclusions: Our study suggests that lymphocytes may play a key role in coronary instability by determining activation of various cellular types throughout the coronary circulation. Activated T lymphocytes and their products may well represent a new target in both the treatment and prevention of acute coronary syndromes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / immunology*
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / immunology*
  • Coronary Vessels / pathology*
  • Female
  • Flow Cytometry
  • HLA-DR Antigens / immunology
  • Humans
  • Immunophenotyping
  • Male
  • Microscopy, Confocal
  • Middle Aged
  • Myocardial Infarction / etiology
  • Myocardial Infarction / immunology*
  • Myocardial Infarction / physiopathology
  • T-Lymphocytes / immunology*


  • HLA-DR Antigens