Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study

ABSTRACT

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.