Coronary artery diseases manifest in different forms. The pathophysiology of coronary artery diseases are complex in origin and mechanism. There are several factors involved and are contributing together for the atherosclerotic event and its complications. The plaque formation and plaque rupture are the two crucial events which may lead to acute myocardial infarction, one of the manifestations of coronary artery diseases. The matrix are involved from the very beginning of the formation of plaque via collagen formation and deposition of lipid particles in the plaque by transforming the smooth muscle cells. An equally crucial event is the plaque rupture, which occurs by the action of matrix degrading metalloproteinases on fibrous plaque leading to extracellular matrix changes subjected to thrombus formation and subsequently to infarction