Key result
Coronary slow flow was associated with significantly impaired endothelial dependent dilatation compared to normal coronary flow (2.78% vs. 6.11%, P<0.01).
Case-Control (n=100)
Absolute Event Rate: 2.78% vs 6.11%
p-value: p=< 0.01
Coronary slow flow phenomenon in angiographically normal coronaries is associated with significantly impaired endothelial function and increased markers of atherosclerosis.
Should not yet change practice in coronary slow flow; leaves open whether endothelial dysfunction or CIMT predicts events.
Background: Coronary slow flow phenomenon (CSFP) is not a benign phenomenon and has been associated with recurrent angina and sudden cardiac death but its etiopathogenesis remains unclear. Aims and Objectives: To evaluate the role of endothelial function in patients with coronary slow flow (CSF) and to compare them with patients with normal coronary flow. Methods: Fifty ( n = 50) patients >18 years of age who presented with history of angina and whose coronary angiogram revealed normal epicardial coronaries with slow flow were included in the study. Fifty patients who presented with chest pain with normal epicardial coronaries and normal flow were taken as controls. Results: There were no major differences in terms of mean age, sex distribution, prevalence of hypertension, diabetes, smoking status, lipid profile, haemoglobin, blood glucose, serum creatinine levels in between the two study groups ([Table 1]). A significant difference was found in the hs-CRP levels between the two groups (5.52 + 3.03 vs. 2.98 + 1.48 mg/L, P < 0.0001). CIMT was found to be significantly more in patients with CSF group than that in patients with normal coronary arteries and normal coronary flow (NCF group) (0.058 + 0.007 cm vs. 0.0045 + 0.005 cm, P < 0.0001). Percentage of endothelial dependent dilatation in patients with CSF group was significantly lesser than in NCF group (2.78 ± 0.10% compared with 6.11 ± 0.10%, P < 0.01). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and patients with NCF (7.4 + 1.1% compared with 8.1 ± 1.0%, P = 0.87). Conclusion: Coronary slow flow phenomenon is a marker of atherosclerosis (as documented by carotid intima media thickness) and our study has also shown that endothelial function is significantly impaired in patients with coronary slow flow (as documented by impaired endothelial dependent vasodilatation) than that of patients with normal epicardial coronaries with normal flow.
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Srikanth Nathani (2016) conducted a case-control in Coronary slow flow phenomenon (n=100). Coronary slow flow vs. Normal coronary flow was evaluated on Percentage of endothelial dependent dilatation (p=< 0.01). Coronary slow flow was associated with significantly impaired endothelial dependent dilatation compared to normal coronary flow (2.78% vs. 6.11%, P<0.01).
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