Protein expression patterns and histologic characteristics of coronary atherosclerosis from sudden cardiac death

Abstract

To identify the distinct histologic and immunohistochemical characteristics of coronary atherosclerosis in sudden cardiac death patients, we analyzed these characteristics in 2 study groups: a sudden cardiac death group (group A) and a noncardiac death group (group B). The plaques in group A that caused sudden cardiac death showed vulnerable features, including necrosis, thin fibrous cap over lipid core, disruption, hemorrhage, thrombus, cholesterol cleft formation, inflammatory cell infiltration, and vasa vasorum formation, more frequently and severely than in group B, and this difference had statistical significance. Immunoreactivity for CD68, ubiquitin, endothelin-1 was significantly higher in group A than in group B. In addition, immunoreactivity for P2Y(12), CRP, and ubiquitin was higher in group A than in group B. Therefore, CD68, ubiquitin, and endothelin-1 may play a role in plaque vulnerability as a mediator of inflammation or vasoconstriction leading to sudden cardiac death.