RELATIONSHIP BETWEEN THE HEMORHEOLOGICAL PROFILE OF PATIENTS AND THE SEVERITY OF CORONARY ATHEROSCLEROSIS

Highlights

• In this study, using direct measurement of arterial blood viscosity, no association was found between hemorheological parameters and the prevalence or severity of coronary atherosclerosis assessed by the SYNTAX score. These findings suggest that the adverse effects of increased blood viscosity, described in several previous studies, are likely mediated not by the progression of atherosclerotic disease but through other pathophysiological mechanisms. The uniqueness of this study lies in the use of a certified rotational viscometer for direct measurement of arterial blood viscosity, which distinguishes it favorably from most previous investigations based on indirect, calculated methods.

Aim. To evaluate the relationship between hemorheological parameters and the presence and severity of coronary atherosclerosis.

Methods. The study included 303 patients undergoing elective coronary angiography (CAG). The mean age was 65.5 ± 9.5 years; 55% were male. Arterial blood viscosity, sampled directly from the introducer sheath prior to CAG, was measured using a Brookfield DV2TLV (USA) rotational viscometer under standardized and controlled temperature conditions. Measurements were performed at shear rates of 1, 5, 10, 22.5, 45, 90, and 225 s⁻¹. Stiffness and non-Newtonian coefficients were calculated using the power-law model of fluid viscosity. Coronary atherosclerosis was assessed by CAG with subsequent calculation of the SYNTAX score. To minimize imbalance between patient groups, propensity score matching (PSM) was applied using the nearest-neighbor 1:1 method with a caliper of 0.05 and a balance threshold of SMD < 0.2.

Results. A total of 303 patients were included in the study. The main group consisted of 105 patients (34.6%) with angiographically confirmed atherosclerotic lesions (SYNTAX > 0). The comparison group comprised 198 patients (65.4%) with no angiographic evidence of atherosclerosis or with hemodynamically insignificant coronary artery lesions (SYNTAX = 0). Hemorheological parameters, including blood viscosity at various shear rates, stiffness, and non-Newtonian coefficients, did not differ significantly between groups either before or after PSM (p > 0.05 for all parameters). Spearman correlation analysis revealed no statistically significant association between SYNTAX score and hemorheological parameters (r < 0.1, p > 0.05).

Conclusion. This study demonstrated no statistically significant association between arterial blood hemorheological parameters and the prevalence or severity of coronary atherosclerosis. These results suggest that the negative clinical impact of increased blood viscosity in patients with coronary artery disease is not mediated by direct promotion of atherosclerotic progression, but rather by other pathophysiological mechanisms.

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