Effect of Cholesterol Crystals on Plaques and Intima in Arteries of Patients With Acute Coronary and Cerebrovascular Syndromes

Reconstituted High-Density Lipoprotein Attenuates Cholesterol Crystal–Induced Inflammatory Responses by Reducing Complement Activation

“…We have shown a novel function of rHDL that attenuates the proinflammatory effects of CC, potentially skewing the balance between anti-inflammatory and proinflammatory actions in atherosclerotic plaques in a more beneficial direction. Given that CC-induced inflammation is critical in the initiation and progression of atherosclerosis (2,58), the rHDL effect on complement activation could be of significant interest for management of atherosclerosis. …”

Slow-Flow Phenomenon After Stent Deployment in Lipid Rich Plaque Harboring Cholesterol Crystals

“…Furthermore, crystalizedcholesterol atheroma had a substantially higher LCBI compared with another lesion without cholesterol crystal, consistent with the histological studies indicating a significant association between the size of the lipid pool and the risk of cholesterol crystallization. 7, 8 Given that high LCBI has been shown to predict periprocedural myocardial…”

Acute Coronary Syndrome: Pathological Findings by Means of Electron Microscopy, Advance Imaging in Cardiology

“…It is the proportion of fatty core to the fibrous cap that determines the plaque stability. Using SEM, cholesterol crystals (CCs) with intima perforation and tearing have been demonstrated within plaques prepared with ethanol or vacuum dehydration [Abela et al, 2009]. Cholesterol crystals vary in shape and size, perforating the intima of coronary arteries and are strongly associated with acute coronary syndrome and cardiac death as well as with thrombus at rupture and/or erosion sites [Schmid et al, 1980, [Ewence et al, 2008.…”

“…This suggests that cholesterol crystallization is critical to plaque rupture and/or erosion and is associated with thrombosis and clinical events [Abela et al, 2006]. Cholesterol materials expand with crystallization tearing and perforating fibrous tissues [Abela et al, 2009]. Acute coronary syndromes are mainly attributed to plaque rupture or erosion [Sun et al, 2011].…”

“…In design of research on the mechanisms of plaque calcification and identification of treatments to ameliorate plaque calcification, it should be kept in mind that tissues should be prepared without ethanol solvents that dissolve CCs, are highly recommended [Abela et al, 2009]. Accumulated calcium in tissues leads to mitochondrial damage and prevention of cell recovery [Duchen, 2004].…”