A 62-year-old woman from Mumbai with a 20-year history of type 2 diabetes and hypertension undergoes coronary angiography for stable angina. Multiple lesions are noted, and intravascular ultrasound (IVUS) reveals positive remodeling of the vessel wall with eccentric plaque distribution. Histological examination of a biopsy specimen shows smooth muscle cell-rich plaque with collagen deposition and minimal lipid content. What is the most likely explanation for the positive remodeling pattern observed in this patient?