Intraplaque hemorrhage and progression of coronary atheroma.

Abstract in brief

• Intraplaque hemorrhage is common in advanced coronary atherosclerotic lesions and may contribute to plaque vulnerability by increasing free cholesterol from erythrocyte membranes, leading to larger necrotic cores and greater macrophage infiltration.
• The study used staining techniques to identify erythrocyte remnants and iron deposits in different types of coronary lesions, finding that more advanced, vulnerable plaques (thin-cap fibrous atheromas with necrosis) showed significantly higher levels of glycophorin A and iron, indicating prior hemorrhage.
• Experimental rabbit models confirmed that intramural hemorrhage promotes the development of lipid-rich, macrophage-infiltrated plaques with cholesterol crystals, suggesting that hemorrhage accelerates plaque progression and destabilization, increasing the risk of rupture.]