1. The in vitro test for red blood cell aggregation has been improved, the coefficient of variation was decreased to 14.2%. 2. By the improved method the earlier findings were confirmed with high statistical significance that heavy smokers have a significantly higher red blood cell aggregation value in comparison with nonsmokers. 3. It could be shown that other coronary risk factors, especially hypercholesterolaemia, increase the aggregation value too. 4. The aggregation of red blood cells increases in the presence of several coronary risk factors in the same patient to higher values than expected from the addition of the aggregations caused by single risk factors.
Red blood cell aggregation value (AW) was found to be of good diagnostic value ror coronary artery disease. Causes of increased aggregation value were investigated by means of protein analytical methods and standard laboratory techniques in 41 men with angiographically documented coronary artery disease. Best correlation coefficients were found between the red blood cell aggregation value and IgG, precipitable by 25g/1 polyethyleneglycol 6000 (r = 0.536; 2P ≤ 0.001). In coronary artery disease patients with no previous myocardial infarction (N=15) polyethyleneglycol precipitable IgM was found to correlate best with red blood cell aggregation (r = 0.707; 2P ≤ ! 0.01 ). In contrast to these results, patients without coronary stenosis demonstrated no significant correlation between the red blood cell aggregation value and the latter factorsThese results indicate a possible link between coronary artery disease, immune complexes and red blood cell aggregation. Platelet aggregation, as well as the coagulation system may also be influenced by these possibly specific immune complexes.
Summary:The erythrocyte aggregation value (AW) has been determined in groups of patients with and without coronary heart disease (CHD) and in a group of apparently normal subjects, using the Metricell apparatus as described by Kachel et al. The following results were obtained: There was a close correlation between the AW and the existence of CHD or arteriosclerosis of peripheral arteries. The precision of the retrospective prediction of CHD by this noninvasive test in male subjects aged over 45 years (total CHD prevalence = 0.494) was: sensitivity = 0.571, specificity = 0.767. The predictive value of positive tests (PV,,) was 0.706, of negative test (PV,,,) 0.647. The discriminatory ability of the AW test was superior to that of serum cholesterol determinations or measurement of other CHD risk factors made in the same population. The AW rises exponentially with the total score for risk factots for CHD hazard for the subject. It appears, however, from the insignificant correlations observed that there is no direct connection between the AW and any single risk factor.
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