Doxycycline prevents intimal hyperplasia in vitro and may improve patency of the internal thoracic artery

The Role of Matrix Metalloproteinase-9 in Atherosclerotic Plaque Instability

Matrix metalloproteinase-9 (MMP-9) belongs to the MMP family and has been widely investigated. Excessive MMP-9 expression can enhance extracellular matrix degradation and promote plaque instability. Studies have demonstrated that MMP-9 levels are higher in vulnerable plaques than in stable plaques. Additionally, several human studies have demonstrated that MMP-9 may be a predictor of atherosclerotic plaque instability and a risk factor for future adverse cardiovascular and cerebrovascular events. MMP-9 deficiency or blocking MMP-9 expression can inhibit plaque inflammation and prevent atherosclerotic plaque instability. All of these results suggest that MMP-9 may be a useful predictive biomarker for vulnerable atherosclerotic plaques, as well as a therapeutic target for preventing atherosclerotic plaque instability. In this review, we describe the structure, function, and regulation of MMP-9. We also discuss the role of MMP-9 in predicting and preventing atherosclerotic plaque instability.

Micromorphology of Skeletonized and Pedicled Internal Thoracic and Radial Arteries

The objective of the study was to estimate the internal thoracic arteries (ITA) and radial arteries (RA) micromorphologic features by light microscopy after harvesting them using the skeletonization and pedicled methods in patients undergoing coronary artery bypass grafting. The micromorphologic characteristics of ITA and RA were studied by luminous microscopy in 61 patients undergoing coronary artery bypass grafting. A total of 122 ITA and RA segments harvested during surgery, fixed in formalin, and stained with hematoxiline and eosin were evaluated. The mean intima-media thickness of ITA was 9.2 and 134.7 µm and that of RA was 9.1 and 334.2 µm, respectively. In the distal segment of ITA the media-intima relation was 1.5 times bigger than in the proximal segment. None of ITA specimens contained atherosclerotic plaques or lipid inclusions. Atherosclerotic plaques were found in 3 (5%) RA specimens. Other degenerative changes were detected in 30%-74.2% of the specimens: splitting of internal elastic lamina, reduced tortuosity of the internal elastic lamina, and thickening and detachment of the intima; their incidence was associated with the skeletonization of the vessels. In conclusion, the incidence of ITA and RA degenerative changes varies from 30%-74.2% and its increase is associated with the skeletonization of the vessels, which is statistically significant. The media of the RA is 2.5 times thicker than that of the ITA (P < 0.01). This fact shows that RA has higher spasmogenic potential than that of ITA. The distal segment of the ITA has 1.5 times bigger media-intima relation than the proximal segment. Therefore, in case of enough graft length, it is recommended to avoid the distal segment and cut it off.