Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study

Mukhopadhyay, Saibal; Kumar, M Nanda; Yusuf, Jamal; Gupta, Vinod Kumar; Tyagi, Sanjay

doi:10.1016/j.ihj.2017.09.001

Cited by 25 publications

(39 citation statements)

References 27 publications

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“…CSFP was significantly more common in male patients in the present study although on multivariable regression analysis no independent association of male sex with CSFP was found. In a study performed by Mukhopadhyay et al 7 in North Indian population, higher BMI, higher fibrinogen levels and smoking were significantly associated with CSFP but on multivariable regression analysis only BMI was found to have independent association with CSFP. In the present study hypertension, dyslipidemia, smoking and tobacco chewing were independently associated with CSFP patients and hypertension was found the strongest predictor.…”

Section: Discussionmentioning

confidence: 87%

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

Sanghvi

Mathur

Baroopal

et al. 2018

Indian Heart Journal

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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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Section: Discussionmentioning

confidence: 87%

“…This study was undertaken to assess the clinical risk factors for CSFP. To the best of our knowledge, only two studies have been done in Indian population till date 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

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

Sanghvi

Mathur

Baroopal

et al. 2018

Indian Heart Journal

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“…CSF refers to a phenomenon whereby normal or nearnormal major branches of the coronary arteries are observed on coronary angiography but there is delayed blood flow in distal blood vessel upon imaging [2][3][4]. ere is now substantial evidence demonstrating that CSF is a main cause of clinical cardiovascular events such as resting and exertional angina and even myocardial infarction [2,[23][24][25], which severely affect quality of life. However, there is still no effective and appropriate method for the early diagnosis of CSF, which may result in prolonged pain and damage.…”

Section: Discussionmentioning

confidence: 99%

miRNA-22 as a Candidate Diagnostic Biomarker for Coronary Slow Flow

Chen

Wang

2020

Cardiology Research and Practice

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Background. Coronary slow flow (CSF) refers to the phenomenon of delayed distal flow in the absence of lesions detected on coronary angiography. Although the detection rate of CSF has been increasing in clinical practice, early diagnosis is difficult and the factors contributing to this condition remain unclear. Given the increasing demonstration of the roles of microRNAs (miRNAs) in disease and as diagnostic biomarkers, the aim of this study was to analyze the expression of serum miRNA-22 in patients with CSF detected using coronary angiography and its diagnostic efficacy. Methods and Results. A retrospective analysis including 44 patients with CSF and 42 patients with normal coronary flow (control group) was conducted. Additionally, all included patients either did not have visually estimated coronary artery stenosis or had <50% stenosis. Plasma samples were collected from patients in these two groups, and the levels of miRNA-22 were detected. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of serum miRNA-22 in the context of CSF. Results. The expression of serum miRNA-22 was significantly higher in the CSF patients than in the control subjects (P < 0.0001). The area under the ROC curve for miRNA-22 in diagnosing CSF was 0.8293 (95% confidence interval: 0.7313–0.9272), with a sensitivity of 75.0% and specificity of 88.1%. Conclusions. The expression of serum miRNA-22 in CSF is upregulated compared to that in subjects with normal coronary flow and shows relatively high clinical diagnostic efficiency, suggesting a new potential biomarker for the early diagnosis of CSF.

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“…Previous studies [14,17,18] have shown that obesity is an important component in the development of slow blood ow. Obesity will lead to insulin resistance, produce a large number of adipocytokines, and then induce the production of reactive oxygen and lead to the breakdown of endogenous vasodilator nitric oxide, resulting in the imbalance between endothelial systolic and diastolic substances and ultimately leading to endothelial dysfunction.…”

Section: Outcomementioning

confidence: 99%

Prognosis Effects of Interventional Therapy on Patients with Coronary Slow Flow: An Observational Cohort Study

Guo

Guan

Tong

et al. 2020

Preprint

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Background: The phenomenon of slow coronary blood flow is common clinically and is related to the patient experiencing repeated chest distress. The mechanism of slow blood flow is still unclear, and the prognosis after combined interventional therapy is unknown. Therefore, we evaluated the role of interventional therapy in this part of the population through the results of a 2-year follow-up.Methods: A total of 4663 patients who underwent continuous coronary angiography (CAG) were identified. Those patients with primary slow coronary flow were included in the study (n=369). The population was then divided into the PCI group and the N-PCI group. CTFT is used to assess the severity of slow blood flow. The endpoint events were the occurrence of rehospitalization and out-of-hospital death within 2 years. The log-rank test, Kaplan-Meier method, and Cox regression were used to evaluate and analyze the final results.Results: A total of 36 patients were readmitted to hospital, and 14 died suddenly outside the hospital during the follow-up period. Among these patients, 6 and 2 patients comprised the PCI group, while 30 and 12 patients comprised the N-PCI group. Comparison of the two groups showed no significant superiority (15.1% vs 13%, P=0.73). In Cox regression analysis, high BMI (body mass index) was an independent predictor of adverse end events (P=0.024).Conclusions: Interventional therapy may not improve outcomes in patients with slow coronary blood flow. BMI plays an important role in the influence of prognosis. Further research is needed to investigate this conclusion.

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Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study

Abstract: This is the first study to analyze clinical presentation, angiographic profile and risk factors associated with CSF in North Indian population. In this study, we found only BMI to have an independent association with CSF.

Cited by 25 publications

References 27 publications

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

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

miRNA-22 as a Candidate Diagnostic Biomarker for Coronary Slow Flow

Prognosis Effects of Interventional Therapy on Patients with Coronary Slow Flow: An Observational Cohort Study

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