A 58-year-old Indian male with a 20-year history of type 2 diabetes and hypertension presents with acute anterior wall myocardial infarction. Coronary angiography reveals a critical stenosis in the left anterior descending artery. Intravascular ultrasound (IVUS) shows the structure marked **A** — an eccentric fibrofatty atherosclerotic plaque in the intima with a large lipid core, thin fibrous cap, and abundant macrophages at the shoulder region. Which of the following best explains why this plaque morphology is associated with acute coronary syndrome in this patient?