Hemorheological abnormalities in stable angina and acute coronary syndromes

The pathophysiological abnormalities of stable angina (SA) and acute coronary syndromes (ACS) may, in part, be promoted by fluid forces associated with local blood flow and hence by the rheological properties of blood. This study evaluated several hemorheological parameters in 16 healthy controls and in 16 SA, 18 unstable angina (UA) and 19 acute myocardial infarct (AMI) patients; all patients underwent diagnostic angiography following blood sampling. Rheological measurements included whole blood viscosity, plasma viscosity and RBC aggregation via erythrocyte sedimentation rate (ESR) and Myrenne aggregometer indices. Compared to controls, RBC aggregation was significantly elevated in all patient groups (p<0.001), with the rank being AMI>UA>SA. RBC aggregability as tested in 70 kDa dextran exceeded control in all patients. Blood viscosity values calculated at 40% Hct, plasma viscosity and yield shear stress values followed the same pattern (AMI>UA>SA> control); increases of inflammatory markers (i.e., WBC count, hs-CRP) were elevated in all patient groups in the order AMI>UA>SA. Our study thus indicates an association between hemorheological abnormalities and the severity of coronary artery disease, and suggests the merit of evaluating whether therapeutic interventions that normalize blood rheology may reduce the incidence and/or progression of coronary artery disease.