Slow-flow phenomenon after drug-coated balloon angioplasty for lower-extremity arteries is associated with lack of prescribing of calcium channel blockers

This study aimed to investigate the relationship between prescription drugs and the slow-flow phenomenon after drug-coated balloon angioplasty. Of 30 patients, five (17%) presented with the slow-flow phenomenon. Patients with the slow-flow phenomenon were significantly less commonly prescribed calcium channel blockers than those without the slow-flow phenomenon (P ¼ 0.03). There was no intergroup difference in the prescription of angiotensin II receptor blockers and b-blockers. The clinical outcomes, including restenosis, thrombosis, target lesion revascularization, and death, did not differ between groups during the 10-month observation period.

Noninvasive Predictors of Coronary Slow Flow Phenomenon in Patients Presenting with Chronic Coronary Syndrome

Background: Patients with coronary slow flow phenomenon (CSFP) exhibit the following characteristics: Predominantly middle-aged males, the majority have mixed pattern angina, persistent chest pain sensations after therapy, and many have had repeated invasive and non-invasive examinations. Objectives: Our study aimed to determine the base of non-invasive predictors of coronary slow flow phenomenon in patients presenting with chronic coronary syndrome. Patients and Methods: This a case-control study included 100 participants of suspected coronary artery disease were divided into two groups matched in age and sex group I: 50 patients with primary CSFP and group II: 50 patients with normal coronary angiography. Each patient was undergoing to demographic data taking, physical investigation, good hydration, restrict fasting hours requested for coronary angiography, 12 lead-Electrocardiogram (ECG)s were obtained for each patient at rest, laboratory parameters, coronary angiography, treadmill exercise ECG, transthoracic echocardiography to assess the thickness of the left ventricle’s (LV) wall, its interior dimensions, as well as the LV’s ejection fraction (EF) using M-mood method and the aortic propagation velocity. Results: male sex and the Canadian Cardiovascular Society Angina grade’s (CCSA) class 3 were significantly decreased in group I compared to group II and male sex, Diabetes mellitus (DM), smoker and CCSA class 4 were substantially increase in group I compared to group II (P <0.05). P wave max, P Wave dispersion (PWd), corrected QT dispersion (QTcd) at resting ECG, T wave inversion and ST Waves segment depression at stress ECG were significantly increase in group I compared to group II. QTc min was significantly lower in group I compared to group II (P <0.05). LA diameter was significantly increased in group I than group II. Aortic propagation velocity was significantly decreased in group I than group II (P <0.05). Hematocrit, total leucocytic count, mean platelet volume and High-sensitivity C-reactive protein (hsCRP) were significantly increase group I compared to group II (P <0.05). Conclusions: Patients suspected of having a coronary artery disease who are diagnosed with coronary slow flow, male sex, dilated LA, CCSA class 3 or 4, elevated hematocrit value, elevated total leucocytic count, increased mean platelet volume, increased HsCRP, P max, PWd, QTcd, T wave inversion, ST segment depression, and decreased aortic propagation were statistically higher in CSFP patient compared to controls

Investigation of patients with coronary slow flow in terms of periodontal health status

SUMMARY OBJECTIVE: This study aims to evaluate the relationship between periodontal health status and coronary slow flow phenomenon. METHODS: One hundred and two patients who underwent coronary angiography with the diagnosis of stable angina pectoris were included in the study. Patients were divided into two groups: patients with coronary slow flow (Test group) (n=51), and patients with normal coronary angiography (Control group) (n=51). Diagnosis of slow coronary flow was made according to Beltrame criteria by coronary angiography. Demographic characteristics of the participants were recorded. The periodontal health was assessed by clinical periodontal parameters such as probing depth, clinical attachment level, gingival index, plaque index, and bleeding on probing. RESULTS: There were no significant differences between groups as regards the frequencies of hypertension, smoking (p>0.05). As for the periodontal parameters of the study groups, probing depth, gingival index, plaque index, bleeding on probing, and clinical attachment level values were statistically higher in the test group compared to the control group (p<0.05). CONCLUSIONS: Periodontitis might be accepted as one of the underlying causes of coronary slow flow. Patients with coronary slow flow should be evaluated for an underlying periodontal disease, and treatment of periodontal disease can protect against future cardiovascular events.

Analysis of biochemical indexes and risk factors in patients with coronary slow flow phenomenon in high altitude Area / 公共卫生与预防医学

Objective To explore the biochemical indicators of patients with coronary slow flow phenomenon (CSFP) in high altitude areas and to analyze the risk factors of CSFP. Methods A total of 90 CSFP patients with no coronary artery stenosis were selected as the CSFP group (48 patients in high altitude area and 50 patients in low and middle altitude area）and 101 patients with normal blood flow were selected as the control group (50 patients in high altitude area and 51 patients in low and middle altitude area). The biochemical indicators of the patient's admission were obtained, and the high risk factors of CSFP were analyzed. Results ALT, GOT, Na, CK, CG, LDL-C, TG, and ET-1 in the CSFP group were significantly higher than those in the control group (P<0.05), while HDL-C and NO in the CSFP group were lower than those in the control group (P<0.05). CG, TG and ET-1 in the high altitude group were higher than those in the low and middle altitude group (P<0.05), while NO was lower than that in the low and medium altitude group (P<0.05). ET-1 and NO were independent influencing factors of CSFP (P<0.05). Conclusion Dyslipidemia can occur in patients with CSFP, especially in high altitude areas. The change of blood lipid level is an independent influencing factor of CSFP.

Effect of trimetazidine and atorvastatin on coronary no or slow flow phenomenon after emergency percutaneous coronary intervention / 中国综合临床

Objective To investigate the therapeutic effect of trimetazidine(TMZ) and atorvastatin on coronary no-flow/slow-flow phenomenon (CNFP/CSFP) emergency pereutaneous coronary intervention (PCI)Methods Thirty-two patients with acute myocardial infarction were selected as our subjects,who hospitalized from April 2007 to May 2012 after PCI with CNFP/CSFP.Patients were administrated with the TMZ (60 mg/d)and atorvastatin (20 mg/d) for 6 months besides the routine therapy.The changes of the clinical symptoms including ECG exercise test,coronary flow of coronary angiography(CAG) were recorded and the level of serum high sensitivity C-reactive protein (hs-CRP),matrix metalloproteinase-9 (MMP-9),tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) were measured before and after the treatment.Results (1)The symptoms of the patients were improved remarkably;the effective rate was 87.5％ (28/32).The improving rate of ECG was 90.6％.The CTFC of patients after treatment was (20.17 ± 4.36),significantly lower than that of before treatment (35.34 ± 7.43,t =2.409,P ＜ 0.05).(2) The levels of hs-CRP,MMP-9,TNF-a and IL-6 at after treatment were (3.34 ±0.47) mg/L,(173.09 ±42.19) μg/L,(8.47 ±2.09) μg/L,(89.37 ± 18.72) ng/L,lower than that of before treatment ((12.34 ± 2.43) mg/L,(972.68 ± 131.91) μg/L,(23.54 ± 7.48) μg/L,(154.39 ± 42.07) ng/L),and difference were significant (t =2.537,2.789,2.691,2.430,P ＜ 0.01 or P ＜0.05).Conclusion The therapy approach of TMZ and atorvastatin plus routine treatment of nitrate and aspirin showed a better therapeutic effect on CNFP/CSFP.The causes of CNFP/CSFP may relate to inflammation.

The evaluation of efficacy and safety of nicorandil on coronary slow flow phenomenon / 重庆医学

Objective To evaluate the effect and safety of nicorandil on Coronary Slow Flow Phenomenon (CSFP) .Methods The CSFP patients(n=60) were randomly divided into the control group treated with placebo and the treatment group treated with nicorandil .The changes of the clinical symptoms ,the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts were observed before and after treatment .Results The treatment group had a better therapeutic effect than the con-trol group(P<0 .05) .There were significant differences in the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts in treatment group before and after treatment ,which were superior to those of control group (P<0 .05 ,P<0 .01) .The blood routine examinations and hepatorenal function were within the normal range before and after treatment .Conclusion Nicorandil has better therapeutic effect and safety on CSFP .

Coronary Slow Flow Phenomenon Leads to ST Elevation Myocardial Infarction

The exact etiology of the coronary slow flow phenomenon (CSFP) is not certain. CSFP is not a normal variant as it is an absolutely pathological entity. Furthermore, CSFP not only leads to myocardial ischemia but it can also cause classical acute ST elevation myocardial infarction, which necessitates coronary angiography for a definite diagnosis.

Non-invasive analysis coronary artery flow velocity of slow coronary flow phenomenon / 中华超声影像学杂志

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).MethodsTwenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.

The impact of serum uric acid level to CSFP / 中国基层医药

ObjectiveTo investigate on the impact of the serum uric acid (UA) level coronary slow flow phenomenon(CSFP).MethodsSelected 30 cases of coronary slow flow patients as CSFP group,30 cases of patients with coronary heart disease,30 cases of patients with angiographically normal as the control group.The serum UA level was measured in three groups.The CSFP group and the control group were measured left anterior descending,circumflex and right coronary artery TIMI frame count(TFC) value.To analyze the mean TFC value of CSFP patients and the relationship between the serum UA level.ResultsCompared with the control group,the left anterior descending,circumflex and right coronary TFC results were significantly higher(all P ＜ 0.05) in the CSFP group.The mean serum UA level of CSFP group ,control group and CHD group were(340.79 ± 79.40)μmol/L, (220.45 ± 82.34)μmol/L,(42625 ± 87.02) μmol/L, the difference was statistically significant (all P ＜ 0.05).The mean serum UA level and TFC value of CSFP group was positively correlated(r = 0.943, P = 0.007).ConclusionElevated level of serum UA is closely related to the occurrence and development of the CSFP.