Evaluation of prevalence, clinical presentation and risk factors of coronary slow flow phenomenon: a single-center study

Background: The coronary slow flow phenomenon has been revealed to be associated with life-threatening arrhythmias and sudden cardiac death. Currently, clinical features and risk factors of patients with the coronary slow flow phenomenon are incompletely understood. The present study aimed to evaluate the prevalence, clinical presentation, risk factors and evidence of ischemia in patients with coronary slow flow.Methods: This observational study was conducted at a tertiary-care center in India between February 2013 and August 2014. A total of 60 consecutive patients whose coronary angiogram revealed coronary slow flow were included in the study. According to the number of blood vessels involved, patients were divided into group-1 (29 patients with single-vessel disease), group-2 (22 patients with double-vessel disease), and group-3 (9 patients with triple-vessel disease). Clinical presentation and risk factors were compared among groups.Results: Prevalence of coronary slow flow was 2.97% with greater prevalence amongst male patients (p=0.030). Unstable angina was the most common presentation (p=0.030). Among the traditional risk factors, there was a significantly higher prevalence of smoking (p=0.036), family history of coronary artery disease (p=0.049) and dyslipidemia (p=0.045) in group-3 patients compared to other groups. Among all groups, triglycerides (p=0.020), low-density lipoprotein cholesterol (p=0.046), highly sensitive C-reactive protein (p=0.007) levels, homocysteine (p=0.481), and patterns of ECG abnormalities were significantly different between the three groups. In addition, mean frame counts with coronary slow flow phenomenon in left anterior descending artery (p<0.001), left circumflex artery (p<0.001) and right coronary artery (p=0.005) increased significantly with increase in number of vessels involved.Conclusions: Coronary slow flow was relatively common among patients who presented with unstable angina. Male sex, smoking, and dyslipidemia can be considered as independent risk factors for this phenomenon.

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CXCL9: a biomarker for the coronary slow flow phenomenon in patients with coronary artery disease

10.21203/rs.2.13298/v1 ◽

2019 ◽

Author(s):

youfeng Liang ◽

xianhe Lin ◽

yuanyuan Xu ◽

chunmiao Wang ◽

Qi Zhou

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Multivariate Logistic Regression Analysis ◽

Serum Levels ◽

Slow Flow ◽

Flow Phenomenon ◽

Coronary Slow Flow ◽

Ifn Γ ◽

Artery Disease ◽

Coronary Slow Flow Phenomenon

Abstract Background: Atherosclerosis is a chronic inflammatory disease. The pathology underlying the disease consists of accumulation of the extracellular matrix, lipid and inflammatory cells. Coronary Slow Flow Phenomenon (CSFP) is closely related to inflammatory responses, while chemokines play an important role in the progression of atherosclerosis. However, the relationship between chemokines and CSFP is unclear. In this study, our aims were to evaluate the association between CXC Chemokines 9 (CXCL9) levels and CSFP in patients with coronary artery disease. Methods: We studied 46 patients diagnosed with CSFP and classed them as the CSFP group. 50 patients with normal coronary angiography (CAG) were randomly selected as the no-CSFP group in our study. The mean TIMI frame count was used to measure coronary blood flow velocity. The clinical and biochemical index, including serum levels of IL1, IL-6, IL-10, CXCL9, CD40L and interferon-γ (IFN-γ), were analyzed in all subjects. Results: The serum levels of IL-1, IL-6, IL-10, CXCL9, CD40L, IFN-γ and CXCL9 in the CSFP group were significantly higher than those in the no-CSFP group, with the differences being statistically significant (p<0.001). Furthermore, Pearson's correlation analysis reflected a significant positive correlation (r=0.171, p=0.01) in CXCL9 levels. Multivariate logistic regression analysis showed that CXCL9 are important risk factors for CSFP (β=1.795, P=0.000). Subsequent ROC curve analyses indicated that the serum CXCL9 levels demonstrated a high diagnostic value in differentiating patients with CSFP from that of normal controls (Area Under the Curve = 0.758) and the serum CXCL9 level of 131.915 mg/L was a predictor of CSFP, with a sensitivity of 54.3% and a specificity of 96.0%. Conclusions: Our findings are indicative of the potential clinical implications of CXCL9 in the occurrence and development of CSFP.

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