© 1997 American Heart Association, Inc.
Articles |
Tissue Factor Expression on Macrophages in Coronary Plaques in Patients with Unstable Angina
From the Division of Cardiology, Kumamoto University School of Medicine (K.K., H.O., H.Y.); the Second Department of Pathology, Kumamoto University School of Medicine (M.T., K.T.); Division of Cardiology, Kumamoto Chuo Hospital (T.S.); the Division of Cardiology, Saiseikai Kumamoto Hospital (K.H., K.H.), Kumamoto; the Division of Cardiology, Shizuoka City Hospital (A.T.), Shizuoka; The Chemo-Sero-Therapeutic Research Institute (Y.K.), Kumamoto; and the Department of Molecular and Cellular Biology, Primate Research Institute, Kyoto University (S.N.), Inuyama, Japan.
Correspondence to Hisao Ogawa, MD, Division of Cardiology, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto City 860, Japan. E-mail: ogawah{at}kumamoto-u.ac.jp.
Abstract Tissue factor is a membrane-bound glycoprotein that functions in the extrinsic pathway of blood coagulation by acting as a cofactor for factor VII, and the resulting complex leads to thrombin production in vivo. The purpose of the present study is to determine whether macrophages express tissue factor in human coronary atherosclerotic plaques. We examined directional coronary atherectomy specimens from 24 patients with unstable angina and 23 with stable exertional angina. In these specimens, macrophages were detected in 22 (92%) of 24 patients with unstable angina versus 12 (52%) of 23 with stable exertional angina (P=.003). The percentage of macrophage infiltration area was significantly larger in patients with unstable angina than in those with stable exertional angina (17±3% versus 6±2%, P=.008). The immunohistochemical double staining revealed the expression of tissue factor on macrophages in 18 (75%) of 24 patients with unstable angina versus 3 (13%) of 23 with stable exertional angina (P<.0001). Thrombus was identified in 20 (83%) of 24 patients with unstable angina versus 12 (52%) of 23 with stable exertional angina (P=.02). Fibrin deposition was mainly observed around macrophages expressing tissue factor in the patients with unstable angina. We have shown that tissue factor expression on macrophages was more frequent in coronary atherosclerotic plaques in patients with unstable angina. Tissue factor expressed on macrophages may play an important role in the thrombogenicity in coronary atherosclerotic plaques of these patients.
Key Words: immunostaining • tissue factor • unstable angina • macrophages • thrombosis
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