title: Myeloperoxidase may help to differentiate coronary plaque erosion from plaque rupture in patients with acute coronary syndromes.
abstract: Coronary thrombosis is the most frequent final event leading to an acute coronary syndrome. In approximately two-thirds of cases, the thrombus overlies a ruptured plaque, whereas in one-third of cases it overlies an intact plaque with superficial endothelial erosion, a finding showed initially by histopathological postmortem studies and more recently confirmed by in vivo optical coherence tomography imaging. Interestingly, recent observations suggest that mechanisms leading to plaque rupture or erosion are different. In fact, in a recent study, we showed that myeloperoxidase levels in peripheral blood and expression within thrombi overlying the culprit plaque are much higher in patients with plaque erosion than in those with plaque rupture. These observations suggest that innate immunity activation is likely to play a key role, in particular, in plaque erosion and might become a therapeutic target in this subset of patients.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Dato
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D054058:Acute Coronary Syndrome / Q000473:pathology*; D003328:Coronary Thrombosis / Q000473:pathology*; D003331:Coronary Vessels / Q000737:chemistry / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D009195:Peroxidase / Q000032:analysis* / Q000097:blood / Q000502:physiology; D058226:Plaque, Atherosclerotic / Q000737:chemistry* / Q000473:pathology / Q000503:physiopathology; D012422:Rupture, Spontaneous / Q000473:pathology
chemical_list: D009195:Peroxidase