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Published on: January 28, 2020
Erythrocyte sedimentation rate, coronary atherosclerosis, and cardiac mortality
Andrea Natali1, Antonio L'Abbate, Ele Ferrannini
1Department of Internal Medicine, University of Pisa, Italy. anatali@ifc.cnr.it
Insights
The erythrocyte sedimentation rate (ESR) is linked to coronary atherosclerosis (ATS) and predicts cardiac death in men. Higher ESR levels indicate more severe ATS and increased risk of mortality.
Area of Science:
- Cardiology
- Clinical Pathology
- Epidemiology
Background:
- Coronary atherosclerosis (ATS) is a leading cause of cardiac mortality.
- The erythrocyte sedimentation rate (ESR) is a common inflammatory marker.
- The relationship between ESR and ATS extension, and its predictive value for cardiac mortality, requires further investigation.
Purpose of the Study:
- To determine if ESR is associated with the extent of coronary atherosclerosis (ATS).
- To evaluate whether ESR predicts cardiac mortality in patients undergoing angiography.
Main Methods:
- Retrospective observational cohort study of 1726 patients undergoing coronary angiography.
- ESR levels were analyzed in relation to the number of diseased coronary vessels.
- Cardiac mortality was assessed over a median follow-up of 92 months.
Main Results:
- ESR was progressively higher with increasing severity of coronary ATS (1, 2, or 3-vessel disease).
- ESR showed a positive association with ATS, independent of other risk factors.
- Patients in the highest ESR quartile had a 1.72-fold increased odds of cardiac mortality.
Conclusions:
- ESR is an independent correlate of coronary ATS.
- ESR predicts cardiac death in male patients with probable ischemic heart disease (IHD).
- ESR may serve as a valuable prognostic marker in cardiovascular disease.
Aims:
To test whether the erythrocyte sedimentation rate (ESR) is related to the extension of coronary atherosclerosis (ATS) and predicts cardiac mortality.
Methods And Results:
Hospital-based, retrospective observational (median follow up: 92 months) cohort study. In 1726 consecutive patients undergoing angiography, coronary ATS and subsequent mortality were related to ESR and to classical risk factors. Patients (n=269) undergoing angiography for reasons different from ischemic heart disease (IHD), served as control. ESR was progressively higher in the presence of 1, 2, or 3-vessel disease. Age-and sex-adjusted ESR was positively related to ATS both in univariate analysis (r=0.17, p<0.0001) and in a multivariate model including principal risk factors (partial r=0.11, p<0.0001). Similar associations were observed in the control group. Over the follow-up period, 170 patients died of a cardiac cause. When male and female patients in their upper ESR quartile (>18 and >23mm/h, respectively) were compared with the remainder of the cohort, their age-and gender-adjusted odds ratio for cardiac mortality was 1.72 (CI=1.25-2.38, p=0.0008). This result held true, in men, also when using a full set of risk factors in a Cox model.
Conclusions:
ESR is an independent correlate of coronary ATS and, in male patients with probable IHD, a predictor of cardiac death.
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