Clinical, demographic, risk factor and angiographic profile of coronary slow flow phenomenon: A single centre experience

Abstract

BackgroundThe coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. Although it is well-known to interventional cardiologists for approximately four decades, the etiopathogenesis still remains unclear.Aims and objectivesIn this study, we aimed to determine the clinical, demographic, risk factor and angiographic profile of patients with CSFP.MethodsClinical, demographic, risk factor and angiographic profile were recorded in all consecutive patients who had undergone coronary angiography between September 2016 and March 2017 and showed features of CSFP and a control group who showed normal coronary flow (NCF). The CSFP was diagnosed on the basis of the corrected thrombolysis in myocardial infarction frame count.ResultsCSFP was significantly more prevalent in male patients. Among the traditional risk factors, there was significantly more prevalence of hypertension (31.25% versus 6.67%, p < 0.001), dyslipidemia (40% versus 7.5%, p < 0.001) and history of tobacco use (47.5% versus 10.0%, p < 0.001) in CSFP patients as compared to NCF patients. On multivariable regression analysis hypertension, dyslipidemia, history of smoking and tobacco chewing were found to have independent association with CSFP. Acute coronary syndrome (ACS) was the most common mode of presentation in CSFP patients.ConclusionCSFP was relatively common among patients who presented with ACS. Hypertension, dyslipidemia, smoking and tobacco chewing can be considered independent risk factors for this phenomenon. Therefore, CSFP should be considered as a pathological entity and not an entirely benign condition.

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“…Patients with CSF may admit to the outpatient clinic with atypical chest pain, exercise angina, unstable angina pectoris, non-Q MI and Q wave MI [8]. The left anterior descending (LAD) artery is most often involved, followed by RCA and the Cx [9]. In our study, distribution of slow flow was similar to these results.…”

Evaluation of the Correlation between Serum Concentrations of Asymmetric Dimethylarginine and Corrected TIMI Frame Count in Patients with Slow Coronary Flow

“…CSFP is an important clinical, angiographic finding because it can result in angina during rest or exercise, acute myocardial infarction, and hypertension in some patients [ 9 ]. CSFP can be marked by delayed filling of the terminal vessels in the absence of epicardial coronary artery obstruction [ 2 ].…”

“…Coronary slow flow phenomenon (CSFP) is an angiographic finding that is diagnosed by delayed terminal vascular filling in the absence of significant epicardial CAD [ 2 ]. However, the exact etiology is still unknown [ 3 ].…”

“…CTFC shows the number of frames needed for the contrast agents to achieve the standardized terminal coronary artery. The normal TIMI frame count of the LAD vessel (36.2 ± 2.6) is 1.7 times longer than the left circumflex artery (LCX) (22.4 ± 2.1) and the right coronary artery (RCA) (20.3 ± 4) vessels [ 2 ].…”

New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

“…For example, Bayramoglu et al [32] and Mazhar et al [33] found that advanced age, lower-left ventricular ejection fraction, stent length of ≥20 mm, thrombus burden, Killip class ≥3, and longer pain-to-balloon time are independent predictors of NRP. Similarly, anterior infarctions, [34] hypertension, dyslipidemia, a history of smoking, and a history of tobacco use [35] have also been shown to be associated with NRP. In the present study, we demonstrated that Killip class, stent length, and CK-MB are independent predictors of NRP.…”