title: Time to rheology in acute myocardial infarction: inflammation and erythrocyte aggregation as a consequence and not necessarily as precursors of the disease.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  The results indicate that erythrocyte aggregation and inflammation increase as time from clinical symptom onset lengthens during the course of AMI.
authors.affiliation: Departments of Medicine "D" & "E", The Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel. arikst@tasmc.health.gov.il
authors.forename: Arie
authors.initials: A
authors.lastname: Steinvil
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: Dan
authors.initials: D
authors.lastname: Justo
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Ariel
authors.initials: A
authors.lastname: Finkelstein
authors.forename: Shmuel
authors.initials: S
authors.lastname: Banai
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000503:physiopathology; D017023:Coronary Angiography; D004903:Erythrocyte Aggregation; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology; D012212:Rheology; D013997:Time Factors
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