THE ERYTHROCYTE sedimentation rate (ESR) is commonly employed for the clinical evaluation of acute myocardial infarction.* Ever since the ESR was introduced into medical practice by Fahraeus, in 1921,13 it has been known that the fibrinogen concentration of the plasma is of foremost significance in the production of rapid settling of the red blood cells. Frequently, however, secondary factors influence the suspension stability of the blood, such as the various globulins,† cholesterol,17 the viscosity of the plasma,‡ the size of the red blood cells,‡ the volume of packed red cells,§ and the electrostatic charge of the proteins and the red blood cells.16 It is obvious, therefore, that a method which depends on a great number of factors is bound to produce bizarre results even under the most carefully controlled conditions and even when a standardized technique is used.
Thus, a method would offer a distinct clinical advantage if it were
LOSNER S, VOLK BW, WILENSKY ND. FIBRINOGEN CONCENTRATION IN ACUTE MYOCARDIAL INFARCTIONComparison of the Clot Density Determination of Fibrinogen with the Erythrocyte Sedimentation Rate. AMA Arch Intern Med. 1954;93(2):231–245. doi:10.1001/archinte.1954.00240260067006
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