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    • br Introduction Atherothrombosis is associated with the pres

    2022-03-22


    Introduction Atherothrombosis is associated with the presence of a low-grade, subclinical smoldering inflammatory response [1]. Several inflammatory markers, among them high-sensitive C-reactive protein (hs-CRP) [2], the erythrocyte sedimentation rate (ESR) [3], fibrinogen concentrations [4], interleukin-6 (IL6) [5], serum amyloid A [6] and other markers of the acute phase response [7] have been shown to be related to the degree of the atherosclerotic process. These markers are relevant not only for the determination of the intensity of the inflammatory response, but have prognostic implications as well [8]. The identification and quantitation of this response might be relevant once therapeutic interventions are considered [9]. We recently introduced a new diagnostic concept for the evaluation of the degree of the inflammatory response [10], [11], [12], [13]. This concept is practically a global assessment of the acute phase response, based on the observation that various acute phase proteins participate in the induction and maintenance of increased erythrocyte aggregability [14], [15], [16]. Thus, by using simple electro-optical devices, we could easily quantitate the degree of the adhesiveness/aggregation of the acamprosate calcium sale [17]. We found that the degree of this adhesiveness/aggregation does, indeed, correlate with the intensity of the inflammatory response as determined by the classical markers, i.e. hs-CRP, ESR, quantitative fibrinogen and the white blood cell count (WBCC). In addition, we could show that the direct observation of the erythrocyte adhesiveness/aggregation [18] might be superior to either erythrocyte sedimentation or quantitative fibrinogen in the differentiation between individuals with ischemic vascular diseases and controls [11].
    Patients and methods
    Results The Pearson correlation coefficients between the various clinical and laboratory variables and the VR (the degree of erythrocyte adhesiveness/aggregation) are reported in Table 1. The EAAT correlated significantly with the ESR and quantitative fibrinogen in both the male and female groups. However, hs-CRP correlated with the VR only in the male group. The correlation between the VR and the clinical profile of the subjects was significant in both groups for age and lipid profile (with HDL and triglycerides for females and with LDL, total cholesterol and triglycerides for males). There was no correlation between the hematocrit level and the VR for both the male and the female groups. We divided the results of the EAAT into four equal quartiles in the women and men groups. We then evaluated the proportion of subjects with atherosclerotic risk factors in each quartile and calculated the χ2-test results. Table 2, Table 3 present the results for the women and for men, respectively: the proportion of individuals with atherosclerotic risk factors increase with the intensity of the erythrocyte adhesiveness/aggregation. We evaluated the number of atherosclerotic risk factors in relation to the EAAT quartiles. The results of the χ2-test, which were borderline in significance for the women (P=0.056) and significant (P<0.0001) for men, are given in Table 4 and suggest taxonomy the multiplicity of risk factors is associated with a higher degree of erythrocyte adhesiveness/aggregation. We then divided the subjects into five groups according to the number of their atherosclerotic risk factors and compared the mean±SD of the variables of the acute phase response in each group. The results are presented in Table 5: there was a significant difference for all variables with the exception that the hs-CRP which was not significant for the women. We further sub-divided our cohort into two main groups of atherosclerotic risk factors, i.e. those with no or one risk factors and those with two or more (multiple) risk factors. The proportions of the women and men with no and one or multiple risk factors in relation to the degree of the EAAT are reported in Table 6 and proved to be significant for both the women (χ2-test P=0.001) and the men (χ2-test P<0.0001). This finding indicates that individuals with multiple atherosclerotic risk factors have an increased degree of erythrocyte adhesiveness/aggregation.