Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Abstract

The coronary slow flow phenomenon (CSFP) is a poorly recognized clinical entity characterized by delayed distal vessel opacification in the absence of epicardial coronary stenosis and presently lack of specific data on the clinical profile and outcome. We investigated a cohort of 429 patients who fulfilled the criteria for CSFP to explore the clinical feature, outcome, and risk factor of prognosis. Two teams (clinical center and core lab) were blind to patient data for the assessment of coronary angiograph using corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). The study cohort consisted of 429 patients (294 men, 68.5%), aged from 30 to 78 years (mean, 54 years). Two hundred patients (46.6%) out of 429 patients had a history of hypertension, 72 (16.8%) had diabetes mellitus, and 222 (51.7%) had dyslipidemia. All the rates of agreement between two teams in evaluating whether normal flow (CTFC ≤ 27 frames) or slow flow (CTFC > 27 frames) were moderate (0.40 < κ < 0.75) for the three arteries. Follow-up (mean, 3.8 years) was done for 421 patients (98.1%). The major adverse cardiovascular events (MACE) occurred in 39 patients (9.3%) out of 421 patients. Multivariate analysis showed that the risk of MACE approximately doubles with age >50 years (hazard ratio (HR) = 2.2, 95% CI: 1.0 to 4.9, and P=0.042), hypertension (HR = 2.1, 95% CI: 1.1 to 4.2, and P=0.021), and dyslipidemia (HR = 2.0, 95% CI: 1.0 to 3.9, and P=0.042). CSFP affects predominantly patients at middle age and above but can occur in any age group; CSFP should be more concerned, particularly in patients >50 years old with hypertension and dyslipidemia.

Yüksek beta-2 mikroglobulin düzeyleri koroner yavaş akım fenomeni için öngördürücü olabilir

“…55% of the study population was male but there was no relation established between sex and CSFP in this paper. Although previous observational studies have concluded that these patients have good prognosis, Zhu et al revealed that an age above 50 and dyslipidemia are associated with adverse outcome in patients with CSF [11]. The mean age of the CSF group was 53 and the groups differed in terms of LDL and total cholesterol levels in our study.…”

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

“…CSF is a significant angiographic complication (15)(16)(17) that is usually characterized by an overlap between the injection of contrast medium in a coronary angiography and when this dye passes through the coronary artery (18). CSF is a common disease (19) that is more easily recognized in patients with acute coronary syndrome (20,21).…”

Hidden Coronary Atherosclerosis Assessment but Not Coronary Flow Reserve Helps to Explain the Slow Coronary Flow Phenomenon in Patients with Angiographically Normal Coronary Arteries

“…Clinical Implications. The SCFph is not without clinical consequences, as reported [ 38 ]. Angina is the major clinical complaint, confirmed in our SCFph series.…”