The process of atherosclerotic plaque destabilization, leading to myocardial infarction, is still not fully understood. The pathway – composed of structural and regulatory proteins of the extracellular matrix (ECM) such as collagen, elastin, small leucine‐rich proteoglycans, metalloproteinases, cathepsins and serine proteases – is one potential way of atherosclerotic plaque destabilization. The expression of these proteins is controlled by different microRNA molecules. The goal of this paper is to summarize the current investigations and knowledge about ECM in the process of atherosclerotic plaque destabilization, giving special attention to epigenetic expression regulation by microRNA. This article is protected by copyright. All rights reserved.