Erythrocyte aggregation as an early biomarker in patients with asymptomatic carotid stenosis
Einor Ben Assayag1, Irena Bova, Anat Kesler
1Department of Neurology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Erythrocyte aggregation (EA) and erythrocyte sedimentation rate (ESR) are sensitive biomarkers for detecting carotid atherosclerosis burden. These tests may help quantify microinflammation in patients with this condition.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biology
- Diagnostic Biomarkers
Background:
- Atherosclerosis is a chronic inflammatory disease.
- Microinflammation plays a key role in the pathogenesis of atherosclerosis.
- Early detection of atherosclerotic burden is crucial for patient management.
Purpose of the Study:
- To evaluate erythrocyte aggregation (EA) as a microinflammatory biomarker.
- To assess the correlation between EA and carotid artery stenosis.
- To compare the sensitivity of EA and ESR with hs-CRP in detecting carotid atherosclerosis.
Main Methods:
- A cohort of 510 neurologically asymptomatic outpatients was studied.
- Carotid artery stenosis was assessed using image analysis.
- Erythrocyte aggregation (EA) was measured using a slide test.
Main Results:
- A significant correlation was found between carotid stenosis severity and EA (r=0.209, p<0.001).
- Erythrocyte sedimentation rate (ESR) and white blood cell count also correlated with stenosis severity.
- High-sensitivity C-reactive protein (hs-CRP) did not effectively discriminate significant carotid atherosclerotic disease.
Conclusions:
- EA and ESR are more sensitive than hs-CRP for detecting significant carotid atherosclerotic burden.
- These inflammatory biomarkers may aid in the detection and quantification of microinflammation.
- EA testing offers a potential tool for assessing microinflammation in carotid atherosclerosis.
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 and r=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.
