Increased High Sensitive CRP Level and Its Significance in Pathogenesis of Slow Coronary Flow

Abstract

Previous studies have suggested that microvascular abnormalities cause slow coronary flow (SCF). The role of inflammation has not been investigated, to date. The purpose of this study was to determine the role of inflammation in pathogenesis of SCF. The study included 32 patients with angiographically proven SCF (mean age 49 +/-9 years) (group I) and 30 subjects with normal coronary flow (mean age 48 +/-8 years) (group II). Blood samples were collected for high sensitive CRP (hs-CRP) measurements. Thrombolysis in myocardial infarction frame count (TFC) was compared in both groups. Distribution of sex, age, body mass index (BMI), arterial blood pressure, and ejection fraction were similar in the 2 groups. TFC was significantly higher in group I than in group II for each artery including left anterior descending coronary artery (LAD), left circumflex artery (Cx), and right coronary artery (RCA) (38.9 +/-6.6 vs 22.1 +/-1.8 frames, p = 0.0001; 39.6 +/-4.9 vs 22.3 +/-1.8 frames, p = 0.001 ; 39.0 +/-3.8 vs 22.0 +/-1.8 frames, p = 0.001, respectively). In group I, serum hs-CRP concentration was significantly higher than that of group II (0.6 +/-0.58 vs 0.24 +/-0.1 mg/dL p = 0.03). Correlation analysis showed a positive correlation between hs-CRP level and TFC for each artery (for CTFC(LAD), r = 0.36 p = 0.004; for TFC(Cx), r = 0.42 p = 0.003; and for TFC(RCA), r = 0.42, p = 0.0001 respectively). Increased hs-CRP level suggests that inflammation may be associated with pathogenesis of SCF or at least in part contributes to its pathogenesis. Increased hs-CRP level may also be an early marker of impaired coronary blood flow.

Increased circulating soluble CD40 levels in patients with slow coronary flow phenomenon: an observational study

“…Even though SCF has been related to inflammatory process, a recent study, comparing SCF patients with normal coronary angiograms also found similar CRP levels (35), which is in line several studies (24,36). On the contrary, there are studies that report increased CRP levels in patients with SCF (37,38). These conflicting results might stem from heterogeneity of recruited patients and/or clinical state of the SCF phenomenon.…”

Increased neopterin levels and its association with angiographic variables in patients with slow coronary flow: an observational study

“…Li et al (8) showed that plasma levels of inflammatory factors, CRP and IL-6 in patients with SCF were found to be significantly higher than those of control subjects. Barutçu et al (9) have found that serum hs-CRP concentration was increased in patients with SCF as compared to control group. On the other hand, Yazıcı et al (20) found that plasma CRP levels were not elevated in patients with SCF when compared with controls.…”

“…Several mechanisms have been proposed for etiology of SCF, including microvascular and endothelial dysfunction, small-vessel disease and diffuse atherosclerosis (1)(2)(3)(4). It has also been proposed that inflammation is another important etiologic factor (5)(6)(7)(8)(9)(10). Its etiopathogenesis is not still clear.…”

Evaluation of Tp-Te Interval and Tp-Te/QT Ratio in Patients with Coronary Slow Flow Tp-Te/QT Ratio and Coronary Slow Flow

“…The pathophysiology of CSF has not been clearly identified yet, although multiple abnormalities including inflammation, oxidative stress, endothelial dysfunction, vasculitis, platelet function disorder and atherothrombosis have been reported [19]. Increased cardiovascular morbidity and mortality have been demonstrated in patients with CSF in previous studies [8].…”