Aims: To test whether the erythrocyte sedimentation rate (ESR) is related to the extension of coronary atherosclerosis (ATS) and predicts cardiac mortality.
Methods and results: Hospital-based, retrospective observational (median follow up: 92 months) cohort study. In 1726 consecutive patients undergoing angiography, coronary ATS and subsequent mortality were related to ESR and to classical risk factors. Patients (n=269) undergoing angiography for reasons different from ischemic heart disease (IHD), served as control. ESR was progressively higher in the presence of 1, 2, or 3-vessel disease. Age-and sex-adjusted ESR was positively related to ATS both in univariate analysis (r=0.17, p<0.0001) and in a multivariate model including principal risk factors (partial r=0.11, p<0.0001). Similar associations were observed in the control group. Over the follow-up period, 170 patients died of a cardiac cause. When male and female patients in their upper ESR quartile (>18 and >23mm/h, respectively) were compared with the remainder of the cohort, their age-and gender-adjusted odds ratio for cardiac mortality was 1.72 (CI=1.25-2.38, p=0.0008). This result held true, in men, also when using a full set of risk factors in a Cox model.
Conclusions: ESR is an independent correlate of coronary ATS and, in male patients with probable IHD, a predictor of cardiac death.