Inflammatory Differences in Plaque Erosion and Rupture in Patients With ST‐Segment Elevation Myocardial Infarction

Background Plaque erosion causes 30% of ST‐segment elevation myocardial infarctions, but the underlying cause is unknown. Inflammatory infiltrates are less abundant in erosion compared with rupture in autopsy studies. We hypothesized that erosion and rupture are associated with significant differences in intracoronary cytokines in vivo. Methods and Results Forty ST‐segment elevation myocardial infarction patients with P 2  pg/mL; P =0.042). IFC was associated with preferential expression of epidermal growth factor (significance analysis of microarrays adjusted P 2  pg/mL, P =0.036) and thrombospondin 1 (significance analysis of microarrays adjusted P =0.03; ELISA IFC 10.4 versus RFC 8.65 log 2  ng/mL, P =0.0041). Thrombectomy mRNA showed elevated I‐TAC in RFC ( P =0.0007) epidermal growth factor expression in IFC ( P =0.0264) but no differences in expression of thrombospondin 1. Conclusions These results demonstrate differential intracoronary cytokine expression in RFC and IFC. Elevated thrombospondin 1 and epidermal growth factor may play an etiological role in erosion.