title: Multicentric inflammation in epicardial coronary arteries of patients dying of acute myocardial infarction.
abstract: OBJECTIVE
  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.
authors.affiliation: Anatomic Pathology Division, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy. Spagnoli@uniroma2.it
authors.forename: Luigi Giusto
authors.initials: LG
authors.lastname: Spagnoli
authors.forename: Elena
authors.initials: E
authors.lastname: Bonanno
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mauriello
authors.forename: Giampiero
authors.initials: G
authors.lastname: Palmieri
authors.forename: Antonietta
authors.initials: A
authors.lastname: Partenzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000276:immunology* / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D006684:HLA-DR Antigens