Significant dominance of fibrinogen over immunoglobulins, C‐reactive protein, cholesterol and triglycerides in maintaining increased red blood cell adhesiveness/aggregation in the peripheral venous blood: a model in hypercholesterolaemic patients

Background  It is not clear what is the relative importance of fibrinogen, immunoglobulins, highly sensitive C‐reactive protein (hs‐CRP), cholesterol and triglyceride concentrations on the appearance of aggregated red blood cells in the peripheral blood. Design  Six hypercholesterolaemic patients undergoing regular LDL apheresis that were examined repeatedly before and following the procedure. Results  We determined the degree of erythrocyte adhesiveness/aggregation in relation to the concentration of the above‐mentioned macromolecules in 80 samples. In a linear logistic regression the respective R 2 values for fibrinogen, total cholesterol, triglycerides, hs‐CRP, IgG, IgM and IgA were 0·45 ( P  < 0·0001), 0·2 ( P  < 0·0001), 0·02 ( P  = 0·02), 0·001 ( P  = NS) and 0·002 ( P  = NS), respectively. We further analyzed the potential of ApoA, ApoB and Lpa to participate in red cell adhesiveness/aggregation and found them to be not significant. Conclusions  In a milieu of adhesive macromolecules, lipids and inflammation‐sensitive proteins including fibrinogen, total cholesterol, triglycerides, hs‐CRP and immunoglobins G, M and A, fibrinogen has a dominant role in maintaining the red blood cell adhesiveness/aggregation in the peripheral venous blood. These findings are relevant for the research directed at finding new apheretic modalities to reduce the degree of red blood cell adhesiveness/aggregation in the peripheral blood.