Long-Term Follow-up of Patients with Coronary Slow Flow Phenomenon

Sadamatsu, Kenji; Koga, Yasutoshi; Tashiro, Hironori

doi:10.1007/s40256-017-0241-4

Cited by 5 publications

(7 citation statements)

References 5 publications

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“…Little is known about the prognosis of true primary CSFP, because the most published literature has included patients with known heart failure, near-normal coronary arteries (<40% stenosis), and other unexplained diseases [12, 13], and as a result, their outcome was not substantially the same as that observed in this study. In this study, we have tried to exclude patients with a possible secondary form of CSFP and other disease states as has been said before by sticking to very strict inclusion and exclusion criteria.…”

Section: Discussionmentioning

confidence: 69%

“…As previously mentioned, there is a paucity of specific data on the outcome of the patients with CSFP, not only that, there is considerable controversy regarding the prognosis. Sadamatsu et al and Chaudhry et al reported that patients with CSFP had a favorable long-term prognosis [13, 14], while Fragasso et al investigated 12 patients with CSFP by an averaged follow-up of 15 years and thought that patients with CSFP were associated with a worse cardiac prognosis and should be carefully followed-up [15]. Besides that, the number of patients reported was limited (from a dozen to over a hundred); so, this phenomenon (CSFP) remains poorly understood.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Zhu

Shen

Gao

et al. 2019

Cardiology Research and Practice

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The coronary slow flow phenomenon (CSFP) is a poorly recognized clinical entity characterized by delayed distal vessel opacification in the absence of epicardial coronary stenosis and presently lack of specific data on the clinical profile and outcome. We investigated a cohort of 429 patients who fulfilled the criteria for CSFP to explore the clinical feature, outcome, and risk factor of prognosis. Two teams (clinical center and core lab) were blind to patient data for the assessment of coronary angiograph using corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). The study cohort consisted of 429 patients (294 men, 68.5%), aged from 30 to 78 years (mean, 54 years). Two hundred patients (46.6%) out of 429 patients had a history of hypertension, 72 (16.8%) had diabetes mellitus, and 222 (51.7%) had dyslipidemia. All the rates of agreement between two teams in evaluating whether normal flow (CTFC ≤ 27 frames) or slow flow (CTFC > 27 frames) were moderate (0.40 < κ < 0.75) for the three arteries. Follow-up (mean, 3.8 years) was done for 421 patients (98.1%). The major adverse cardiovascular events (MACE) occurred in 39 patients (9.3%) out of 421 patients. Multivariate analysis showed that the risk of MACE approximately doubles with age >50 years (hazard ratio (HR) = 2.2, 95% CI: 1.0 to 4.9, and P=0.042), hypertension (HR = 2.1, 95% CI: 1.1 to 4.2, and P=0.021), and dyslipidemia (HR = 2.0, 95% CI: 1.0 to 3.9, and P=0.042). CSFP affects predominantly patients at middle age and above but can occur in any age group; CSFP should be more concerned, particularly in patients >50 years old with hypertension and dyslipidemia.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Zhu

Shen

Gao

et al. 2019

Cardiology Research and Practice

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“…The coronary slow flow phenomenon (CSFP) is characterized by delayed distal blood flow (1) that occurs despite coronary angiography showing no coronary lesions (2)(3)(4). Before a diagnosis of coronary slow flow (CSF) can be made, other potential causes must first be excluded.…”

Section: Introductionmentioning

confidence: 99%

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

2021

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Background: To explore the relationship between coronary slow flow (CSF) and both matrix metalloproteinase-9 (MMP-9) and soluble cluster of differentiation 40 ligand (sCD40L).Methods: Between July 2016 and September 2019, 80 patients suspected of having coronary heart disease due to chest tightness or other symptoms of chest pain and discomfort were admitted to Nanjing Jiangbei People's Hospital and, following a coronary angiography, were diagnosed as having CSF. These patients were assigned to the coronary slow flow phenomenon (CSFP) group. The control group, or normal coronary flow (NCF) group, consisted of 80 patients with normal coronary angiography results. Following group assignment, enzyme-linked immunosorbent assays (ELISAs) were used to measure and compare the serum levels of sCD40L and MMP-9 between the two groups.Results: Serum levels of sCD40L and MMP-9 in the CSFP group were significantly higher than those in the NCF group (P<0.05). Additionally, serum levels of adhesion molecules and C-reactive protein (CRP) in the CSFP group were significantly higher than those in NCF group (P<0.05). There was a positive correlation observed between sCD40L levels and adhesion molecule levels in the CSFP group, however, there was no such correlation observed in the NCF group. The CSFP group also had a significantly higher corrected TIMI frame count (CTFC) compared with the NCF group (P<0.05).Conclusions: Serum MMP-9 levels were higher in patients with CSF, and MMP-9 levels were positively correlated with CTFC. This suggests that chronic inflammation may play a role in CSF pathogenesis and that atherosclerotic plaques may be present in the coronary arteries of CSF patients. Additionally, serum levels of sCD40L, adhesion molecules, and CRP were higher in CSF patients, and CRP levels were positively correlated with CTFC. Adhesion molecule expression is promoted by sCD40L. Increased levels of sCD40L may therefore promote the development of CSF.

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“…Repeat angiography was required in 9.5% of our patients, with a mean interval length of 3.6 years. Sadamatsu et al 10 assessed only 11 CSF patients, but none suffered major adverse cardiac events or required repeat angiography. Sadr-Ameli et al 12 reported repeat angiography in 36 out of 217 patients within 5 to 7 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“… 9 Nonetheless, other studies have suggested a benign course without significant morbidity and mortality. 10 There are controversies surrounding the course and prognosis of CSF patients. 11 – 14 Long-term cohorts can help better understand the physiopathology and outcome of this group of patients.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Prognosis in Patients with Coronary Slow Flow

Mikaeilvand¹,

Hajizadeh²,

Bateni³

et al. 2023

JTHC

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Background: Coronary slow flow (CSF) is defined as decreased coronary blood circulation velocity and delayed opacification of contrast media during angiography. Evidence is insufficient regarding the course and prognosis of CSF patients. Long-term follow-up can help better understand the physiopathology and outcome of CSF. Accordingly, we assessed the long-term outcomes of CSF patients in this study. Methods: This retrospective cohort study was carried out on 213 CSF patients consecutively admitted to a tertiary health care center from April 2012 through March 2021. After data collection from the patients’ files, follow-up was done via telephone call invitations and assessments of existing data in the outpatient cardiology clinic. The comparative analysis was conducted using a logistic regression test. Results: The mean follow-up length was 66.26±15.32 months, 105 patients (52.2%) were male, and the mean age of the patients was 53.81±11.91 years. The left anterior descending was the main affected artery (42.8%). At long-term follow-up, 19 patients (9.5%) required repeated angiography. Three patients (1.5%) had a myocardial infarction and 5 (2.5%) died from cardiovascular etiologies. Three patients (1.5%) underwent percutaneous coronary intervention. No patient required coronary artery bypass grafting. The need for a second angiography had no association with sex, symptoms, and echocardiographic findings. Conclusion: The long-term outcome of CSF patients is good, but their follow-up is necessary for the early diagnosis of cardiovascular-related adverse events.

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Long-Term Follow-up of Patients with Coronary Slow Flow Phenomenon

Cited by 5 publications

References 5 publications

Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

Long-Term Prognosis in Patients with Coronary Slow Flow

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