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European Heart Journal 2003 24(7):639-648; doi:10.1016/S0195-668X(02)00741-8
Copyright © 2003 by the European Society of Cardiology.
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Erythrocyte sedimentation rate, coronary atherosclerosis, and cardiac mortality

Andrea Natalia,*, Antonio L'Abbateb and Ele Ferranninia

a Department of Internal Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy
b Coronary Division of the C.N.R. Institute of Clinical Physiology, University of Pisa, Via Roma 67,Pisa 56100, Italy

* Correspondence author. Tel.: +39-050-99-2814; fax: +39-050-55-3235
E-mail address: anatali{at}ifc.cnr.it

Received 26 August 2002; revised 8 October 2002; accepted 9 October 2002

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 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 (, ) and in a multivariate model including principal risk factors (partial , ). 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 (, ). 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.

Key Words: Erythrocyte sedimentation rate • Inflammation • Coronary atherosclerosis • Cardiac mortality • Risk factors • Ischemic heart disease


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