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Comparison of ADAMTS-1, -4 and -5 expression in culprit plaques between acute myocardial infarction and stable angina
  1. Cheol Whan Lee1,
  2. Ilseon Hwang2,
  3. Chan-Sik Park3,
  4. Hyangsin Lee4,
  5. Duk-Woo Park1,
  6. Su-Jin Kang1,
  7. Seung-Hwan Lee1,
  8. Young-Hak Kim1,
  9. Seong-Wook Park1,
  10. Seung-Jung Park1
  1. 1Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
  2. 2Department of Pathology, School of Medicine, Keimyung University, Choong-Ku, Daegu, Korea
  3. 3Department of Pathology, Asan Medical Center, University of Ulsan, Seoul, Korea
  4. 4Asan Institute of Life Science, University of Ulsan, Seoul, Korea
  1. Correspondence to Seung-Jung Park, Division of Cardiology, Asan Medical Center, University of Ulsan, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea; sjpark{at}


Background ADAMTS (a disintegrin and metalloproteinase with thrombospondin type 1 motifs) proteases might contribute to plaque destabilisation by weakening the fibrous cap. However, little is known about the expression of ADAMTS proteases in coronary atherosclerotic plaques.

Objective To examine the expression of ADAMTS proteases in coronary atherectomy samples obtained from patients with acute myocardial infarction (AMI) or stable angina.

Methods Atherectomy specimens were obtained from 34 patients with AMI (n=23) or stable angina (n=11) who underwent directional coronary atherectomy. The specimens were stained with H&E and analysed immunohistochemically using antibodies specific to ADAMTS-1, -4 and -5; versican cleavage products; and markers for endothelial cells, macrophages and smooth muscle cells.

Results Baseline characteristics were similar between the two groups. The proportion of CD31 and CD68 immunopositive areas did not differ between the two groups, but the area immunopositive for smooth muscle α-actin was smaller in the AMI group. The relative area immunopositive for ADAMTS-1 in AMI (1.04% (IQR 0.59–2.09%)) was significantly greater than that in stable angina (0.24% (0.15–0.39%); p<0.001). In contrast, the proportion of areas immunopositive for ADAMTS-4 or -5 was similar in the two groups. Areas that stained for ADAMTS-1 largely overlapped with those positive for CD68 and versican cleavage products. The areas immunopositive for ADAMTS-1 were significantly correlated with CD68 immunostained areas (r=0.50, p=0.003).

Conclusions ADAMTS-1, -4 and -5 were present in human coronary atherosclerotic plaques, and ADATS-1 was more strongly expressed in AMI plaques than in stable plaques. ADAMTS-1 may play a role in plaque instability.

  • Atherosclerosis
  • heart
  • vascular disease

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  • CWL and IH contributed equally to this paper.

  • Funding This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (A090264).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Review Committee of the University of Ulsan.

  • Provenance and peer review Not commissioned; externally peer reviewed.