A Simple Slide Test to Assess Grades of Erythrocyte Aggregation in Acute ST-Elevated Myocardial Infarction and Its Prognostic Significance

A simple slide test and analysis of image was used to reveal the presence of an acute-phase response in subjects of acute myocardial infarction. Erythrocytes tend to aggregate when an inflammatory process like atherosclerosis in coronary artery disease. Evaluation of erythrocyte adhesiveness/aggregation (EAAT) is currently available to the physicians indirectly by Erythrocyte sedimentation rate (ESR).The ESR correlates poorly with erythrocyte aggregation, hence a simple slide test using citrated blood was used to evaluate erythrocyte aggregation in grades by microscopically and also by using image analysis. AIM OF THE STUDY: To study erythrocyte aggregation and adhesiveness by a simple slide test in subjects with acute ST-elevated myocardial infarction (STEMI) in predicting the outcome within 1week. METHODS AND MATERIALS: Fifty patients of acute STEMI who came to the ICCU of Government Royapettah Hospital were included in the study, onset of chest pain within 6hrs, Subjects with retrosternal chest pain persisting for more than30 min and with ST segment elevation 1mm in limb leads and 2mm in chest leads in at least two contiguous ECG leads were included in the study. Citrated blood was subjected to simple slide test and Stained smears were examined under400X and graded into four grades. OUTCOMES: To find out whether there is any statistically significance between the grades of erythrocyte aggregation and prognosis of STEMI patients within 1 week. Good Prognosis: Recovery is good Bad Prognosis: Patient developed reperfusion arrhythmias, LVF, recurrent Infarction, VT and VF, cardiogenic shock, death from cardiac and non cardiac causes. RESULTS: ‘P’ value between the Grades of RBC aggregation and the prognosis of the patients with STEMI was <0.05. CONCLUSION: EAAT is a simple bedside slide test for erythrocyte aggregation, which indirectly find out the presence and proportion of inflammation. This test also has the potential to assess the prognosis of STEMI patients. It can also be used as a screening test for patients with STEMI to find out high-risk individuals so that necessary interventions (like PCI) could be adopted.