Abstract
Background: Atherosclerosis is a chronic inflammatory disease. Design: We have evaluated the degree of erythrocyte aggregation (EA) as a microinflammatory biomarker in a cohort of hospital-based, neurologically asymptomatic outpatients. Methods: The degree of EA and carotid artery stenosis was evaluated in 510 individuals by using a simple slide test and image analysis. Results: Four hundred and sixteen individuals had minimal carotid stenosis (< 30%); 47 had mild to moderate stenosis (30–69%) and 47 had severe stenosis (>70%). A significant correlation was noted between the degree of carotid stenosis and the erythrocyte sedimentation rate (ESR), white blood cell count (WBCC) and fibrinogen (r=0.160, p=0.005;r=0.191, p=0.001 andr=0.126, p=0.026, respectively). The significant correlation was noted between the degree of carotid stenosis and EA (r=0.209, p < 0.001). The subjects with severe stenosis differed significantly from the other groups in their ESR, WBCC and EA. High sensitivity C-reactive protein (hs-CRP) concentrations did not discriminate between the presence and absence of significant carotid atherosclerotic disease. Conclusions: Inflammatory biomarkers such as ESR and the EA test are more sensitive than hs-CRP to the presence of a significant atherosclerotic carotid burden. These biomarkers might aid in the detection and quantification of microinflammation in individuals with carotid atherosclerosis.
Highlights
Recent studies have questioned the usefulness of high sensitivity C-reactive protein for the detection and quantification of the microinflammatory response that is associated with the atherosclerotic disease [1,2,3]
There was an increase in the intake of cardiovascular active drugs in individuals with carotid stenosis
The results indicate that only a weak correlation exists between the degree of stenosis and erythrocyte sedimentation rate (ESR), white blood cell count (WBCC), fibrinogen concentrations and erythrocyte aggregation (EA) measurements, erythrocyte percentage (EP) and vacuum radius” (VR) (r = 0.160, p = 0.005; r = 0.191, p = 0.001; r = 0.126, p = 0.026; r = −0.179, p = 0.002; r = 0.209, p < 0.001, respectively), but patients with significant carotid stenosis have higher levels of the studied biomarkers
Summary
Recent studies have questioned the usefulness of high sensitivity C-reactive protein (hs-CRP) for the detection and quantification of the microinflammatory response that is associated with the atherosclerotic disease [1,2,3]. High sensitivity C-reactive protein (hs-CRP) concentrations did not discriminate between the presence and absence of significant carotid atherosclerotic disease. Conclusions: Inflammatory biomarkers such as ESR and the EA test are more sensitive than hs-CRP to the presence of a significant atherosclerotic carotid burden. These biomarkers might aid in the detection and quantification of microinflammation in individuals with carotid atherosclerosis
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