A simple slide test for erythrocyte aggregability as a risk stratification tool in patients admitted with chest pain to the emergency room

Abstract

Patients presenting to the Emergency Room with chest pain pose a diagnostic challenge because of a possible acute coronary syndrome. This study was done to determine the diagnostic utility of a simple slide test for red cell aggregability in patients with chest pain and as a prognostic indicator in unstable angina. 32 patients of Unstable Angina and 32 persons with non-cardiac chest pain were included in the study. A simple slide was prepared with the peripheral blood of the subjects and stained and assessed by a pathologist and by digital photographs and grid analysis to grade red cell aggregabilty. 19 patients with Unstable Angina had Grade C or D red cell aggregation while only 2 persons with noncardiac chest pain had Grade C aggregation. Estimation of Erythrocyte Percentage from the grid images and calculation of Receiver Operating Characteristic Curve gave a best cutoff value of 60-70 with a lower EP signifying unstable angina. 8 patients with Unstable Angina and an EP <50 developed acute MI or recurrent angina. To conclude, a simple slide test of the peripheral blood helps in the initial evaluation of chest pain patients for possible unstable angina, and, further has prognostic utility in patients with unstable angina.