European Heart Journal Advance Access originally published online on February 15, 2005
European Heart Journal 2005 26(6):624-625; doi:10.1093/eurheartj/ehi152
Haemorheological variables as risk factors of ischaemic heart diseases
1st Department of Medicine
School of Medicine
University of Pécs
Pécs
Ifjúság út 13.
7624 Hungary
Tel: +36 72 536001
Fax: +36 72 536148
E-mail address: gabor.kesmarky{at}aok.pte.hu
1st Department of Medicine
School of Medicine
University of Pécs
Pécs
Ifjúság út 13.
7624 Hungary
1st Department of Medicine
School of Medicine
University of Pécs
Pécs
Ifjúság út 13.
7624 Hungary
We read the paper by Yarnell et al.1 with great interest. It focuses its attention on the predictive power of haemostatic/haemorheologic and inflammatory markers in ischaemic heart diseases, comparing it with that of serum lipids. Although they had a large population in this trial, the role of haemorheological parameters is still under-represented in circulation research and in the clinical practice. In our department, several investigations were performed during the last decade in patients with ischaemic heart diseases as well as with hypertension, diabetes mellitus, and during and after percutaneous coronary interventions.2–4
In one of our studies, the relation of the severity of coronary artery disease and haemorheological factors was studied in patients who underwent coronary angiography. In this study, 162 ischaemic heart disease patients consecutively admitted to our department and 59 healthy persons were examined. Besides the usual laboratory parameters, haematocrit, plasma fibrinogen, plasma, and whole blood viscosity were measured; results were also analysed as to whether there was any relation to the severity of coronary artery disease detected by coronary angiography. Haemorheological variables were most deteriorated in those with the most severe coronary vessel disease; patients with non-significant atherosclerotic lesions and single vessel disease showed intermediate alterations of these parameters.2
In another study, we investigated whether haemorheological parameters changed during and after percutaneous coronary angioplasty. In the acute phase following the intervention, and also in the 6-month follow-up period, plasma fibrinogen, plasma, and whole blood viscosity values were demonstrated to elevate, which could result in no-reflow and/or restenosis/re-occlusion, which are, unfortunately, common adverse events after this procedure.3 Similar results could be found previously in patients with acute myocardial infarction, and more recently in those with acute ischaemic coronary syndromes, which demonstrates the involvement of these factors both in the acute inflammatory response and in the chronic atherosclerotic processes.5
A further analysis of the several thousand haemorheological tests performed in our laboratory in the past 15 years is currently under publication. In conclusion, on the basis of the previous investigations and our own results, we also recommend fibrinogen, plasma, and whole blood viscosity as a part of risk stratification and target for novel therapeutic approaches in ischaemic heart diseases.
References
- Yarnell JWG, Patterson CC, Sweetnam PM et al. Haemostatic/inflammatory markers predict 10-year risk of IHD at least as well as lipids: the Caerphilly collaborative studies. Eur Heart J 2004;25:1049–1056.
[Abstract/Free Full Text] - Toth K, Habon T, Horvath I et al. Hemorheological and hemodynamical parameters in patients with ischemic heart disease at rest and at peak exercise. Clin Hemorheol 1994;14:329–338.
- Kesmarky G, Toth K, Habon L et al. Hemorheological parameters in coronary artery disease. Clin Hemorheol Microcirc 1998;18:245–251.[Web of Science][Medline]
- Kesmarky G, Toth K, Vajda G et al. Hemorheological and oxygen free radical associated alterations during and after percutaneous transluminal coronary angioplasty. Clin Hemorheol Microcirc 2001;24:33–41.[Web of Science][Medline]
- Marton ZS, Horvath B, Alexy T et al. Follow-up of hemorheological parameters and platelet aggregation in patients with acute coronary syndromes. Clin Hemorheol Microcirc 2003;29:81–94.[Web of Science][Medline]
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