Spontaneous Myocardial Infarction in a Translational Porcine Model of Coronary Atherosclerosis: A Pilot Study

This pilot study characterizes the spectrum of atherosclerotic coronary artery pathologies in a porcine model of streptozotocin-induced diabetes, with a particular focus on the natural progression of atherosclerotic plaques. Four pigs (designated P01 - P04) were subjected to an identical streptozotocin regimen to induce diabetes and studied using blood biochemistry, lipid profiling, coronary angiography, optical coherence tomography, and histological analysis of the coronary arteries to assess for the development of coronary atherosclerosis. All animals developed sustained hyperglycemia and dyslipidemia, with total cholesterol levels ranging from 14.9 to 36.7 mmol/L and low-density lipoprotein concentrations reaching up to 32 mmol/L. Notably, the study captured the full pathological continuum: from nearly no coronary abnormality in P01 and early atheromatous plaque formation in P02, to advanced atherosclerosis in P03, and finally, in P04, severe fibrofatty atheroma, and myocardial infarction. Unlike conventional animal myocardial infarction models that rely on interventional triggers, the infarction in P04 occurred spontaneously, demonstrating the natural cascade of plaque development and acute plaque rupture with thrombosis. These findings demonstrate the feasibility of using streptozotocin-treated pigs to model key stages of diabetic coronary artery disease.