Role of endothelial function in coronary slow-flow phenomenon with angiographically normal coronaries

Abstract

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 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.