An anatomical pull out image of each layer of the arterial vessel wall. The intima colored light blue is the location of the primary remodeling including the positive outward and later in time the negative inward remodeling with encroachment of the lumen. The inward negative remodeling is associated more with stable angina and stable plaques. The positive outward remodeling is associated more with unstable coronary syndromes and unstable VPs and has a much higher level of MMP-3 (stromelysin-ase) activity which may be increased as is MMP-9 in the diabetic patients. It is the MMPs which allow the tearing down (remodeling) in order for the outward remodeling to occur. See section on Redox Stress and MMP activity.
Hayden and Tyagi Cardiovascular Diabetology 2002 1:3 doi:10.1186/1475-2840-1-3