By examining the coronary arteries and carotid plaques of people who died of heart attacks, researchers from Michigan State University have, for the first time, found evidence of cholesterol crystals disrupting plaque. Specifically, they discovered that as cholesterol builds up along the wall of an artery, it crystallizes from a liquid to a solid state, and then expands. This can disrupt plaque in a patients' cardiovascular system and potentially cause a heart attack or stroke. The breakthrough discovery came when the researchers began using a vacuum dry method instead of an alcohol solution, which would dissolve crystals, to preserve tissues after an autopsy.

"As the cholesterol crystallizes, two things can happen," says George Abela, chief of the cardiology division in MSU's College of Human Medicine. "If it's a big pool of cholesterol, it will expand, causing the ‘cap' of the deposit to tear off in the arterial wall. Or the crystals, which are sharp, needle-like structures, poke their way through the cap covering the cholesterol deposit, like nails through wood." As he explains, the crystals work their way into the bloodstream, triggering the body's natural defence mechanism - clotting. This can lead to the formation of dangerous and potentially fatal clots. Abela also says that crystals released in the bloodstream during a heart attack or stroke are able to cause damage much further away from the original site of attack.

According to the researchers, the findings may "dramatically change how we treat heart disease. So far, treatments have not been focused on this process," says Abela. "Now we have a target to attack with the various novel approaches. In the past, we've treated the various stages that lead to this final stage, rather than preventing or treating this final stage of the condition."

News Release: MSU researcher links cholesterol crystals to cardiovascular attacks   www.news.msu.edu  March 25, 2009