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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.
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Background: The relationship of atrial fibrillation (AF) with coronary artery disease (CAD) is well established, yet it is often missed. There is evidence of myocardial ischemia on stress imaging in AF patients in the absence of obstructive CAD. In this prospective cohort, we studied the angiographic profiles of non-valvular AF patients. Methods: The study was a nonrandomized, prospective, single-center observational study of consecutive patients of persistent non-valvular AF. Patients symptomatic for AF despite optimal medical therapy for 3 months were recruited and all underwent coronary angiograms (CAG). Patients with prior history of CAD were excluded. Results: A total of 70 patients were followed for a mean duration of 12 ± 1.4 months. The mean age of the study group was 66.07 (±11.49) years. Hypertension was the commonest comorbidity seen in 74% patients. Obstructive CAD was present in 32 (46%) patients, non-obstructive (<50% stenosis) CAD in 17 (24%) patients and normal coronaries in 21 (30%) patients. Overall 49 (70%) patients had evidence of CAD. Amongst patients without obstructive CAD, slow flow was seen in 16 (42%) patients. Lower baseline ejection fraction, lower haemoglobin & albumin levels and higher creatinine levels was associated with increased mortality. In patients without obstructive CAD, hospitalizations for fast ventricular rate were significantly increased in those having slow flow on CAG (p ¼ 0.005). Conclusions: Majority (70%) of our patients had evidence of atherosclerotic CAD on CAG. A large proportion of patients without obstructive CAD had slow flow on CAG.
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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
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Objective:To investigate the relationship between sleep quality and slow-flow in patients with acute coronary syndrome during percutaneous coronary intervention(PCI) and its impact on clinical prognosis.Methods:200 patients with ACS hospitalized in the cardiology department of Guangzhou First People's Hospital from January 2017 to October 2018 were selected. The Pittsburgh Sleep Quality Index (PSQI) was measured before elective PCI, and the sleep breathing of patients was monitored by micro motion sensitive mattress sleep monitoring system (MSMSMS). The patients were divided into normal sleep group (68 cases, PSQI≤7 points) and sleep disorder group (132 cases, PSQI>7 points). The levels of plasma endothelin-1 (ET-1) and nitric oxide (NO) were measured. The " slow-flow" that took place during PCI were also recorded. Major cardiac adverse events (MACE) of patients took placed during 12 months follow-up periods were recorded and compared between two groups.Results:Compared with normal sleep group, patients in sleep disorder group had higher ratio of sleep apnea-hypopnea syndrome (SAHS), hypoxemia and lower deep sleep (25.00% vs 10.29%, 25.76% vs 11.76%, 66.67% vs 48.53%, all P<0.05); lower level of NO and higher level of ET-1 [(28.65±3.26)μmol/L vs (30.24±4.08)μmol/L; (21.17±3.08)pg/ml vs (18.90±2.95)pg/ml, P<0.05]; more slow-flow events took place during PCI in sleep disorder group than normal sleep group (16.67 vs 5.88%, P<0.05); After 12 months of follow-up, Kaplan-Meier survival analysis showed patients of the two groups had significantly different cumulative non-events survival rates (19.70% vs 7.35%, Log rank=5.06, P=0.025). Conclusions:Sleep disorder increase the slow-flow phenomenon during PCI in patients with ACS and affect the clinical prognosis.
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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.
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Humanos , Enfermedades Periodontales/diagnóstico por imagen , Periodontitis , Fumar , Índice Periodontal , Estado de SaludRESUMEN
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.
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Objective To investigate the factors related to slow-flow (SF) or no-reflow (NR) during the percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary sydrome (NSTEACS). Methods Patients diagnosed as NSTEACS who received PCI from September 2007 to June 2018 were collected through the data base of medical record management system in Qingdao Eighth People′s Hospital.The blood flow≤TIMI 2 grade during PCI was defined as slow-flow (SF) or no-reflow(NR). Patients with SF or NR were included into the case group and patients without SF or NR were included into the controlled group. Factors of age, gender, history of hypertension, history of type 2 diabetes, history of high cholesterol, history of smoking, history of drinking, NSTEACS risk stratification, the application of platelet glycoprotein (GP) ⅡB/ⅢA receptor antagonist, coronary artery SYNTAX score, culprit blood vessels, times of balloon dilatation, the burden of thrombus and the preoperative TIMI grade of blood flow were analyzed by multivariate Logistic regression. Then, variables screening was performed through backward method and likelihood ratio test. Results A total of 3 927 patients with NSTEACS receiving PCI were enrolled. After patients with incomplete information were eliminated, 143 patients were admitted to the case group and 3 588 patients were admitted to the control group. After the analysis of multivariate Logistic regression and variables screening, it was showed that times of balloon dilatation ≥ 3 ( OR＝1.725, 95% CI 1.211－2.358, P＝0.014) and high burden of thrombus ( OR＝1.821, 95% CI 1.322-2.511, P＜0.01) were the risk factors of SF or NR, while the application of GPⅡB/ⅢA receptor antagonist ( OR＝0.623, 95% CI 0.382-0.855, P＝0.012) was the protective factor of SF or NR. Conclusions Multiple balloon dilatation and high burden of thrombus increased the risk of SF or NR, while the application of GPⅡB/ⅢA receptor antagonists could inhibit the occurrence of SF or NR.
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Background “Coronary slow flow’’ (CSF) is delayed vessel opacification in the absence of epicardial stenosis. Studies in different ethnic groups have found variable risk factors associated with CSF. Aim of present study was to analyze the risk factors and angiographic profile of CSF in North Indian population, not studied till date. Methods 40 patients with CSF and 40 controls were studied. CSF was determined quantitatively by thrombolysis in myocardial infarction (TIMI) frame count method. Various clinical risk factors (age, sex, body mass Index (BMI), diabetes, hypertension, dyslipidemia, smoking), hematological and biochemical parameters (hematocrit, platelet count, uric acid, homocysteine, fibrinogen, high sensitivity C reactive protein (hsCRP), glycosylated hemoglobin (HbA1c) were assessed. Results Of the 40 patients with CSF, 37 (92.5%) were males. While 20 patients (50%) presented with chronic stable angina, rest 20 (50%) presented with acute coronary syndrome. [15 (37.5%) with unstable angina and 5 (12.5%) with non ST elevation myocardial infarction (NSTEMI)]. Patients with CSF had significantly higher BMI (27.27 ± 2.82 vs. 24.12 ± 2.35, p < 0.001), fibrinogen levels (398.48 ± 120.96 vs. 331.55 ± 162.6, p = 0.04) and smoking (24(60.0%) vs 14(35.0%), p = 0.02). On multivariable regression analysis, only BMI was found to have an independent association with CSF (odds ratio 1.613, 95% confidence interval 1.265–2.057, p < 0.001). Conclusion This is the first study to analyze clinical presentation, angiographic profile and risk factors associated with CSF in North Indian population. In this study, we found only BMI to have an independent association with CSF.
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Objective To evaluate left ventricular systolic and diastolic functions of patients with coronary slow flow (CSF) according to left ventricular myocardial systolic/diastolic performances (MSP/MDP) by using two-dimensional speckle tracking echocardiography (STE).Methods Fifty patients with CSF diagnosed with coronary angiography (CSF group) and 45 patients without CSF (control group) underwent STE.Left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate were measured,and left ventricular MSP and MDP were calculated,then the results were statistically analyzed between the 2 groups.Results Compared with control group,left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate,MSP and MDP reduced in CSF group (all P＜0.05).The mean thrombolysis in myocardial infarction (TIMI) frame count (TFC) of coronary artery was negatively correlated with MDP (r=-0.23,P=0.04),and the number of affected coronary arteries was negatively correlated with MDP (r=-0.31,P=0.03).There was significant difference of MDP among patients with different numbers of affected coronary arteries and control group (all P＜0.05),and MDP in affected 2 and 3 coronary arteries patients were lower than those of the control group (all P＜ 0.05).Conclusion Left ventricular systolic and diastolic functions is impaired in patients with CSF.The mean TFC and the number of affected coronary arteries are negatively correlated with left ventricular diastolic function.Left ventricular MSP and MDP are comprehensive parameters in evaluating systolic and diastolic functions.
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Coronary slow flow phenomenon (CSFP) is an angiographic diagnosis characterized by delayed peripheral coronary perfusion in the absence of significant epicardial coronary lesions.Cardiac structure and systolic function of most patients had no abnormality,but there might be recurrent chest pain with impairment in quality of life.Therefore,it is very important to diagnose and assess CSFP using noninvasive,easy and safe technique.With the development of echocardiography in recent years,CSPF can be quantitatively and qualitatively analyzed with conventional echocardiography,two-dimensional and three-dimensional speckle tracking echocardiography and myocardial contrast echocardiography.Progresses of echocardiography in evaluating CSFP were reviewed in this article.
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Objective To observe the effect of nicorandil on slow-flow phenomenon in percutaneous coronary intervention (PCI) in patients with acute non-ST segment elevated myocardial infarction (NSTEMI). Methods A total of 159 NSTEMI patients were enrolled. Based on the TIMI flow of target lesion blood vessels after PCI, patients were divided into two groups. There were 31 cases in no flow/slow flow group (TIMI≤2), and 128 cases in normal group (TIMI=3). The general clinical data, immediate TIMI flow grade of infarct-related artery (IRA) after PCI treatment, post-operative corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), thrombolysis in myocardial infarction signs of a blood clot, number of diseased vessels and major adverse cardiac events were compared between the two groups. The patients in no flow/slow flow group were given nicorandil, and changes of blood flow before and after treatment were observed. The influence factors of no flow/slow flow were analyzed by multifactor Logistic regression. Results The proportions of patients with history of smoking, the proportion of patients with diabetes history, the proportion of patients with hyperlipidemia, the proportion of patients with low blood pressure in operation, and the number of implanted stents, the proportions of patients took tirofiban in operation, post-operative CTFC, the proportions of patients with thrombosis signs were significantly higher in no flow/slow flow group than those in the normal group (P<0.05). There were no significant differences in heart rates in operation, IRA distribution and the number of lesion vessels between the two groups. There were also no significant differences in the incidence of MACE and left ventricular ejection fraction between the two groups. After the application of nicorandil, the proportion of patients with TIMI blood flow 3 and proportions of cTFC and TMPG were significantly higher than before treatment (P<0.05). Results showed that smoking history, history of diabetes, multiple stents (more than 3), hypotension in PCI, and signs of blood clot were factors influencing the slow flow of coronary arteries. Conclusion Nicorandil can significantly improve the no flow/slow flow in PCI in patients with NSTEMI.
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Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.
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Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.
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Objective To investigate the curative effect of benidipine hydrochloride on patients with coronary slow flow angina pectoris(CSFA).Methods Sixty cases patients with CSFA were randomly divided into two groups of 30 patients each.In the control group patients were received aspirin(100 mg,1 times/d) and atorvastatin(20 mg,1 times/d) as basic treatment;in the treatment group patients were received basic treatment plus benidipine hydrochloride(4 mg,1 times/d).Follow up for 6 mouths,the effectiveness rate of treatment(relief of angina and electrocardiogram of myocardial ischemia),the correction of thrombolysis in myocardial infarction(TIMI) frame count(CTFC) before and after the different intervention,and the incidence of adverse cardiovascular events were compared between the treatment group and the control group.Results The effectiveness rate of treatment in the treatment group(86.7%,26/30) was significantly higher than that in the control group(63.3%(19/30);χ2=4.356,P=0.037).There were significant reductions of CTFC in both groups after the different intervention(treatment group:(28.43±3.95) frames vs.(18.40±3.73) frames,t=10.254,P=0.000;control group:(27.87±4.14) frames vs.(21.87±4.17) frames,t=5.580,P=0.000).There was more significant reductions of CTFC in the treatment group as compared to the control group(t=2.138,P=0.037).The incidence of adverse cardiovascular events in the treatment group(10.0%(3/30)) was significantly lower than that in the control group(33.3%(10/30),P=0.028).Conclusion Benidipine hydrochloride is effective in the treatment of CSFA.
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Objective To study the correlation between the risk factors of coronary slow flow phenomenon ( CSF) and the level of plasma D-dimer in patients with ACS ( acute coronary syndrome) after emergency percutaneous coronary intervention ( PCI) .Methods A total of 297 patients with ACS after PCI were enrolled for retrospective analysis.All patients were divided into CSF group and control group in the light of corrected thrombolysis in myocardial infarction (TIMI) frame count method (cTFC).Multivariate analysis for evaluating clinical predictors of CSF was carried out using Logistic regression test and Pearson analysis to find the correlation between plasma D-dimer and cTFC.The predictive value of D-dimer level in the occurrence of coronary slow flow was determined by using receiver operating characteristic ( POC) curve analysis.Results CSF was observed in 59 cases (19.8%).The plasma D-dimer was significantly higher in the coronary slow flow group compared with the control group ( P <0.05 ) .Multivariate regression analysis and Logistic regression test showed that the level of plasma D-dimer ( OR =1.276, 95%CI:1.132-3.224, P=0.012), thrombus score (OR =1.108, 95%CI: 1.085-2.103, P =0.018) and target lesion length of culprit vessel ( OR =1.436, 95%CI: 0.635-1.382, P =0.037 ) were the risk factors of CSF.Correlation analysis showed that plasma D-dimer were positively associated with CSF. Receiver operating characteristic ( ROC ) curve analysis showed that D-dimer cutoff point at 515.3 ng/ml had a good judgment significance ( AUC 0.783, OR =1.502, 95%CI: 1.324-2.531, P =0.005). Conclusions The increased D-dimer level is a risk factor and plays an important role in the ACS patients with the CSF phenomenon, thereby predicting no-reflow phenomenon after primary PCI in these patients.
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Objective To investigate the effect of fasudil on vascular endothelial function in patients with coronary slow flow( CSF) . Methods Eighty?two patients with CSF and normal coronary angiography were selected and randomly divided into conventional treatment group and fasudil group, 41 cases in each group. Patients in conventional treatment group were given conventional treatment( aspirin,nitrates and atorvasta?tin) ,while patients in the fasudil group were given fasudil on the basis of conventional treatment. The angina pectoris,TIMI,endothelial?dependent flow?mediated vasodilation( FMD) ,the levels of plasma nitric oxide( NO) , endothelin?1( ET?1) and Rho kinase( ROCKI) of the brachial artery were observed in the two groups before and after two weeks of treatment. Results The total effective rate of fasudil group was 87. 80%,higher than that of conventional treatment group of 65. 85%,the difference was significant(χ2=68. 176,P<0. 05) . TIMI,FMD im?proved in the fasudil group after treatment compared with before treatment, the difference was significant ( t =4. 37,4. 43;P<0. 05);plasma NO level increased compared with before treatment(t=5. 63,P<0. 01),while ROCKI,ET?1 level decreased(t=6. 19,5. 66;P<0. 01). Plasma NO,ET?1,ROCKI and FMD,TIMI of conven?tional treatment had no significantly changes before and after treatment(P<0. 05). The post?treatment of NO, FMD,TIMI levels in fasudil group were significantly increased compared with conventional group ( ( 36. 17 ±7. 64) μmol/L vs. (24. 99±8. 96) μmol/L,(9. 96±1. 76)% vs. (5. 86±1. 45)%,17. 53±5. 81 vs. 29. 71 ±7. 83;t=4. 06,4. 18,5. 41;P<0. 05),while ROCKI,ET?1 levels in fasudil group were significantly decreased compared with conventional group((19. 57±1. 33) μg/L vs. (34. 38±1. 51) μg/L,(14. 36±6. 05) ng/L vs. (20. 95±6. 57) ng/L;t=3. 87,4. 36,P<0. 01). Conclusion Fasudil can significantly improve the vascular en?dothelial function in patients with CSF.
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Objective To investigate the effects of bisoprolol combined with rosuvastatin on endothelial function and inflammation in patients with coronary slow flow (CSF). Methods Ninety CSF patients treated from August 2014 to October 2015 were randomly divided into control group, statin group and combined group, thirty cases in each group. The control group was given conventional therapy (aspirin 100 mg/d and isosorbide mononitrate 60 mg/d), statin group was given rosuvastatin 10 mg/d on the basic of control group, while the combined group was given bisoprolol 5 mg/d on the basic therapy of statin group. The serum concentrations of nitric oxide (NO), endothelin-1(ET-1), high-sensitivity c-reactive protein (hs-CRP) and interleukin-6 (IL-6) were detected before treatment and 8 weeks after treatment. The improvement of patients with angina pectoris was evaluated. Results After eight-week treatment, the NO levels were significantly increased in combined group and statin group, while the ET-1, hs-CRP and IL-6 levels were significantly decreased than those before the treatment (P<0.05). At the same time, comparing with the statin group and control group, the NO level was increased in combined group (P<0.05), while the ET-1, hs-CRP, and IL-6 levels decreased significantly (P<0.05). There were significant differences in the effective rates between the combined group (90.0%) and the statin group (83.3%), which were higher than those in control group (56.7%). Conclusion Bisoprolol combined with rosuvastatin can improve the endothelial function and anti-inflammatory in the treatment of CSF.
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Objective The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course,but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates.Methods Coronary angiographies of 3368 patients were selected to assess thrombolysis in myocardial infarction (TIMI) frame count (TFC) values.Seventy eight of them had CSFP,and their demographic and laboratory findings were compared with 61 patients with normal coronary flow.Results Patients'demographic characteristics were similar in both two groups.Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (P ＜ 0.001).Furthermore,hematocrit and hemoglobin values,and eosinophil and basophil counts of the CSFP patients were significantly elevated compared with the values obtained in the control group (P =0.005,P =0.047,P =0.001 and P =0.002).The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r =0.288 and r =0.217).Conclusion Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow.The increases inhematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.
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Objective To investigate the carotid arterial stiffness in patients with coronary slow flow ( CSF) .Methods forty-five patients with CSF and Forty -five persons having normal coronary arteries ( NCA) detected by coronary angiography with a similar distri-bution of risk factors were recruited .Stiffness parameter (β), pressure-strain elastic modulus (Ep), arterial compliance (AC) and lo-cal pulse-wave velocity (PWV) were obtained at the level of bilateral carotid artery by a real time echo -tracking system.Serum levels of high-sensitivity C-reactive protein ( hs-CRP) were measured in two groups of subjects .Linear regression analysis were performed to evaluate the correlation between hs -CRP and the parameters of the carotid artery stiffness .Results We found that stiffness parameter (β), Ep and PWV were significantly higher in CSF group those that of control group (β:11.80 ±3.19 vs 9.70 ±3.76,P<0.01;Ep:149.90 ±44.47 vs 130.10 ±41.56,P<0.05;PWV:7.40 ±0.84 vs 7.00 ±1.08,P<0.05), AC was lower than that of control group (0.640 ±0.180 vs 0.760 ±0.192 ,P<0.01).The levels of high-sensitivity C-reactive protein (hs-CRP) was significantly higher in CSF group than that of control group (13.90 ±10.66 vs 9.30 ±6.33,P<0.05).The levels of hs-CRP was positively correlated with theβ(r=0.272,P=0.005), Ep(r=0.411,P=0.003), and PWV(r=0.452,P=0.001), but negatively correlated with AC (r=-0.293,P=0.025).Conclusion Echo-tracking technology is a simple practical method to evaluate carotid artery stiffness in patients with CSF and correlation well with coronary slow flow and artery stiffness .