Predictors of coronary slow flow in stable coronary artery disease

Although several studies have shown that endothelial dysfunction and inflammation may play roles in coronary slow flow phenomenon (CSFP), its etiology and pathogenesis still unclear and based on this observation our aim was detection of clinical and laboratory predictors of primary CSFP judged by TIMI frame count in coronary angiography (CA) for stable coronary artery disease patients (SCAD). Case control study included 120 patients with SCAD who underwent CA. They were classified into two groups: PCSF group and normal coronary flow group. All patients subjected to CBC, platelet count, leucocytic count (total and differential), platelet-to lymphocyte ratio (PLR), neutrophil-to lymphocyte ratio (NLR), uric acid, albumin, Hs.CRP levels and CA with TIMI frame count. Incidence of diabetic mellitus and smoking were significantly higher in PCSF compared to control (P = 0.01), also we found PLR, NLR, uric acid and Hs-CRP levels were significantly higher in PCSF compared to control (P < 0.0001). The sensitivity of PLR ≥ 150, NLR ≥ 2, albumin level ≤ 3.5 g/dl, uric acid ≥ 6 mg/dl and Hs.CRP ≥ 6 mg/L for prediction of CSFP were (83.3%, 90.0%, 50.0%, 76.7% and 83.3% respectively) while the specificity were (86.7%, 90.0%, 53.3%, 83.3% and 86.7%) respectively. The multivariate analysis showed NLR ≥ 2 as the only independent predictor of PSCF. PCSF was common in smokers and diabetic patients and this phenomenon is associated with high PLR, NLR, Serum uric acid and Hs.CRP. The only independent predictor of CSFP was neutrophil-to lymphocyte ratio (NLR).