Time to rheology in acute myocardial infarction: inflammation and erythrocyte aggregation as a consequence and not necessarily as precursors of the disease

Previous studies have demonstrated the presence of increased erythrocyte aggregation (EA) in patients with acute coronary syndromes (ACS). We have presently explored the correlation between the time from symptom onset to the appearance of an inflammatory response and aggregated erythrocytes in the peripheral blood of ACS patients. Consecutive individuals undergoing coronary catheterization at the Tel-Aviv Souraski medical center were enrolled. Matched controls were fitted for each case in order to compare the EA and inflammatory response in each time quartile from symptom onset. Linear regression models were fitted for wide-range C-reactive protein (wr-CRP), fibrinogen and for the Vacuum R a measure of EA, as the dependant variables and adjusted to multiple cardiovascular risk factors, relevant medications as well as to time from symptom onset to angiography. The study population comprised 428 male patients, 223 with unstable angina and 205 with acute myocardial infarction (AMI). A significant time-dependant increase in the concentrations of inflammation-sensitive biomarkers as well as EA has been noted only in the AMI group. Time from onset of pain to angiography entered as a significant predictor of fibrinogen, wr-CRP, and VR (r (2) = 0.24, p < 0.001; r (2) = 0.18, p < 0.001; r (2) = 0.6, p = 0.04; respectively). The results indicate that erythrocyte aggregation and inflammation increase as time from clinical symptom onset lengthens during the course of AMI.