Immunohistochemical and Morphometric Evaluations of Coronary Atherosclerotic Plaques Associated with Myocardial Infarction and Diabetes Mellitus

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Abstract
Immunohistochemical and morphometrical studies were performed to elucidate the specificity of atherosclerosis in the descending branch (the segments 5 and 6) of the left coronary artery associated with acute myocardial infarction (AMI) in the anterior wall of the heart and non-insulin-dependent diabetes mellitus (NIDDM). The NIDDM without AMI group showed diffuse intimal thickening with smooth muscle cells, combined with much more intense immunostaining of tenascin than the non-diabetic groups. The AMI without NIDDM group showed atheromatous thickening with decreased smooth muscle cells, a large number of macrophage and TUNEL-positive cells compared with the groups without AMI. However, the AMI with NIDDM group revealed atherosclerotic lesion with decreased smooth muscle cells, increased macrophages and TUNEL-positive cells associated with the increased localization of tenascin and TGF-/31 compared with the control. These findings suggest that the specificity of coronary atherosclerosis in diabetic patients may be the extensive athero-sclerotic changes associated with increased tenascin. In AMI with NIDDM, increased TGF-β1may induce apoptosis in the atheroma and coronary dysfunction, contributing to the development of acute myocardial infarction.

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