title: Role of erythrocyte sedimentation rate in ischemic stroke as an inflammatory marker of carotid atherosclerosis.
abstract: BACKGROUND
  Inflammation mediates a key role in the pathogenesis of atherosclerosis which is an important cause of ischemic stroke. An elevated erythrocyte sedimentation rate (ESR) may, therefore, be a marker of the extent andor intensity of a general atherosclerotic process and thus a marker for advanced atherosclerosis heralding increased risk of arterial thrombosis leading to ischemic stroke.
  
  
  METHODS
  ESR was calculated in ischemic stroke patients by Westergren's method along with carotid sonography using high resolution 7.5 MHz techniques to find the prevalence of increased carotid intima-media thickness (CIMT) and presence of plaque according to Mannheim Carotid Intima-Media Thickness Consensus.
  
  
  RESULTS
  Average value of ESR in all patients was 27.89 ± 9.73 mm/h. A significant association was found between ESR and markers of carotid atherosclerosis, that is, high CIMT of more than 0.8 mm (P < 0.0001) and presence of plaque (P-0.026) in univariate analysis. Also, a significant positive correlation was found between ESR and serum fibrinogen, another inflammatory marker. (r = 0.88, P < 0.0001).
  
  
  CONCLUSIONS
  The extent of inflammation may reflect in part the propensity of atherosclerotic lesions to lead to clinical disease. Study shows the association of ESR with markers of atherosclerosis confirming the strength of the inflammatory response associated with carotid atherosclerosis and might conceivably carry important prognostic information regarding occurrence of such catastrophic events in future.
authors.affiliation: Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Amit Shankar
authors.initials: AS
authors.lastname: Singh
authors.affiliation: Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Atam
authors.affiliation: Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Besthenahalli Erappa
authors.initials: BE
authors.lastname: Yathish
authors.affiliation: Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Liza
authors.initials: L
authors.lastname: Das
authors.affiliation: Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Seiddhartha
authors.initials: S
authors.lastname: Koonwar
keywords: Arterial thrombosis; atherosclerosis; cerebrovascular disease; inflammation; ischemic stroke; plaque
references.citation: Stroke. 1990 Nov;21(11):1567-72
references.pmid: 2237950
references.citation: N Engl J Med. 1999 Jan 14;340(2):115-26
references.pmid: 9887164
references.citation: Lancet. 1986 Sep 6;2(8506):533-7
references.pmid: 2875280
references.citation: Cerebrovasc Dis. 2007;23(1):75-80
references.pmid: 17108679
references.citation: Circulation. 1986 Dec;74(6):1399-406
references.pmid: 3536154
references.citation: J Neuroimmunol. 2003 Jun;139(1-2):93-101
references.pmid: 12799026
references.citation: Indian Heart J. 2001 Jul-Aug;53(4):458-62
references.pmid: 11759935
references.citation: J Clin Pathol. 1988 Nov;41(11):1203-12
references.pmid: 2463272
references.citation: Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2646-54
references.pmid: 9409238
references.citation: N Engl J Med. 1997 Apr 3;336(14):973-9
references.pmid: 9077376
references.citation: Circulation. 1997 Dec 16;96(12):4219-25
references.pmid: 9416885
references.citation: Arteriosclerosis. 1986 Mar-Apr;6(2):131-8
references.pmid: 2937395
references.citation: Asian Cardiovasc Thorac Ann. 2003 Sep;11(3):217-21
references.pmid: 14514551
references.citation: Cardiovasc Drugs Ther. 2002 Jul;16(4):341-51
references.pmid: 12652104
references.citation: J Neurosci Rural Pract. 2012 Jan;3(1):21-7
references.pmid: 22346186