Abstract

Introduction: This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. Methods: This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon. Results: In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P <0.001), hyperlipidemic (44.2 vs. 31.7, P <0.001), hypertensive (53.5 vs. 39.1, P <0.001), and smoker (37.2 vs. 27.2, P =0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P <0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P <0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P <0.001) and hypertension (OR 1.59, CI 1.30-5.67, P =0.003) were independent predictors of SCF phenomenon. Conclusion: The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon.

Highlights

  • This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon

  • A total of 11 970 coronary angiographies were performed at Imam Ali Cardiovascular Hospital from March 2016 to March 2019, as a result of which 1 848 (15.43%) patients with normal epicardial coronary arteries (NECA) and 172 (1.43%) patients with SCF phenomenon were identified

  • Mean age of the patients with SCF was equal to 53.07 ± 9.81 years old, and for the patients with NECA, it was equal to 52.17 ± 10.84 years old (P = 0.256)

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Summary

Introduction

This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. It has been reported that 1%–5% of the patients undergoing coronary angiography are suffering from SCF phenomenon.[4,5] SCF phenomenon is more commonly found in young men and current smokers having chest pain.[4] SCF phenomenon involves both small and epicardial coronary arteries and has been suggested as an early phase of atherosclerosis.[6,7] Pathophysiology of SCF phenomenon is not completely known. Endothelial dysfunction, diffuse atherosclerosis, and inflammation are significantly associated with pathogenesis of SCF phenomenon.[4,8,9] Previous studies have reported different clinical risk factors to be independently related to SCF phenomenon .4,10-13

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