Erythrocyte sedimentation rate, coronary atherosclerosis, and cardiac mortality.

Abstract

To test whether the erythrocyte sedimentation rate (ESR) is related to the extension of coronary atherosclerosis (ATS) and predicts cardiac mortality. 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. ESR is an independent correlate of coronary ATS and, in male patients with probable IHD, a predictor of cardiac death.