Morphologic findings of coronary atherosclerotic plaques in diabetics: A postmortem study

Allen P. Burke, Frank D. Kolodgie, Arthur Zieske, David R. Fowler, Deena K. Weber, P. Jacob Varghese, Andrew Farb, Renu Virmani

Research output: Contribution to journalArticlepeer-review

444 Scopus citations


Objective-Coronary atherosclerotic plaque composition of diabetic subjects and localization of receptor for advanced glycation end products (RAGE) and its ligands have not been extensively studied. Method and Results-Hearts from diabetic subjects and age, race, and sex-matched nondiabetic subjects dying suddenly were examined. Coronary arteries were dissected and lesions were evaluated for plaque burden, necrotic core size, and inflammatory infiltrate. The expression of RAGE, the RAGE-binding protein (S100-A12, EN-RAGE), and cell death (apoptosis) were also determined. Lesions from type II diabetic subjects had larger mean necrotic cores (P=0.01) and greater total and distal plaque load (P<0.001) than nondiabetic subjects. Necrotic core size correlated positively with diabetic status, independent of other risk factors. Intimal staining for macrophages, T-cells, and HLA-DR was also significantly greater in diabetic subjects (P=0.03, P=0.003, and P<0.0001), respectively. The association of increased macrophage infiltrate was independent of cholesterol levels and patient age. Expression of RAGE and EN-RAGE was significantly greater in diabetic subjects (P=0.004) and was associated with apoptotic smooth muscle cells and macrophages. Conclusion-In sudden coronary death, inflammation and necrotic core size play a greater role in the progression of atherosclerosis in diabetic subjects. The expression of RAGE and EN-RAGE may further compromise cell survival and promote plaque destabilization.

Original languageEnglish (US)
Pages (from-to)1266-1271
Number of pages6
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Issue number7
StatePublished - Jul 2004


  • Atherosclerosis
  • Diabetes mellitus
  • Receptor for advanced glycation end products
  • S100A12
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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