Analysis Of Clinical Risk Factors Of Coronary Slow Flow Phenomenon

Objective:To probe the clinical risk factors of coronary slow flow phenomenon.Methods:236 cases of suspected coronary heart disease patients that were admitted with chest pain in the department of cardiology in the second affiliated hospital of Kunming Medical University from January,2014 to January,2016, and were excluded of obvious stenosis through coronary angiography during hospitalization were successively selected.118 cases out of these patients that showed no obvious stenosis through coronary angiography and with slow coronary flow were categorized as the slow coronary flow group, while the other 118 cases of patients with normal coronary flow and with no obvious stenosis through coronary angiography during the same period were treated as the normal coronary flow group. Multiple clinical data, such as age, sex, past history[smoking,hypertension,diabetes,obstructive sleep apnea hypopnea syndrome(OSAHS) et al], body mass index (BMI), hematocrit (HCT), plateletocrit (PCT), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid (UA), homocysteine (Hcy), fasting blood glucose (FBG), carotid intima-media thickness (CIMT), left ventricular posterior wall thickness (LVPWT), TIMI frame count of all coronary arteries, thyroid function, and electrocardiographic manifestation were collected for statistical analysis.Results:(1) Age[(58.34±12.7)years old vs.(54.71±11.79)years old,P=0.024], the sex ratio(male/female)(67.80%vs.39.83%,P=0.000), positive rate of smoking history (74. 58%vs.42.37%,P=0.000), of abnormal electrocardiogram (23.73%vs.l2.71%,p=0.02 8),incidence of hypertension(49.20%vs.29.70%,P=0.002), of OSAHS (22.00%vs.9. 30%,P=0.007),BMI[(25.15±3.10)kg/m2vs.(24.34±2.41)kg/m2,P=0.026], HCT[(44.20 ±5.17)vs.(41.97±4.54),P=0.001], PCT[(0.23±0.06)vs.(0.21±0.05),P=0.036],UA[(403. 69±114.54)μmol/L vs.(369.06±104.84)μmol7L,p=0.016],Hcy[(14.86±6.83)μmol/L vs. (12.23±4.01)μmol/L,p=0.000],left CIMT [(1.04±0.16)mm vs.(0.94±0.33)mm,p=0.00 5], right CIMT [(1.10±0.18)mmvs.(0.96±0.31)mm,p=0.000], mean CIMT [(1.07±0.16) mm vs.(0.95±0.31)m,p=0.000] and LVPWT[(10.50±1.61)mm vs.(9.79±1.21)mm,p=0. 000] were higher in the slow coronary flow group than in the normal coronary flow gr oup; while the HDL-C[(0.95±0.24)mmol/L vs.(1.03±0.3)mmol/L,P=0.037] was lowe r in the slow coronary flow group than in the normal coronary flow group;(2) The con-elation of all clinical indices in the slow coronary flow group:mean TFC was positiv ely correlated with BMI; mean CMT was positively correlated with LVPWT; BMI w as positively correlated with TG, UA and LVPWT;BMI was negatively correlated wit h Hey and HDL-C;TG was positively correlated with LDL-C and UA; HDL-C was ne gatively correlated with TG and LDL-C;and UA was positively correlated with HCT, LDL-C and LVPWT; (3)The vascular involvement in patients with slow coronary flo w:LAD single branch involvement accounted for 14.41%in the slow coronary flow g roup; LCX single branch involvement accounted for 78.81%; RCA single branch invo lvement accounted for 3.39%; both LAD and LCX involvement accounted for 0.85%; both LAD and RCA involvement accounted for 1.69%; both LAD and RCA involve ment, or LAD, RCA and LCX involvementwas not seen, and the most common vessel involved was LCX; (4) Multi-factor Logistic regression analysis indicated that age, s ex, smoking, Hey, LVPWT and LDL-C might be the independent risk factors of slow coronary flow genesis; it could be considered that the risk of slow coronary flow gene sis would increase with the increase in age, Hey, LVPWT and LDL-C; the genesis risk was higher in male than in female, and that was higher in smokers than in non-smoke rs; (5) Among the independent risk factors selected, the differences of LCX and mean TFC between LVPWT≤11mm group and LVPWT>11mm group were of statistical significance; the differences of cLAD, LCX, RCA and mean TFC between LDL-C^ 3.4mmol/L group and LDL-C>3.4mmol/L group were of no statistical significance; a nd the differences of LCX and mean TFC between Hcy≤ 10 μ mol/L group and Hey > 10 μ mol/L group were of statistical significance.Conclusions:Age, sex, smoking, Hey, LVPWT and LDL-C were risk factors of the genesis of slow coronary flow; left circumflex artery involvement was most commonly seen in coronary slow flow phenomenon; the blood flow rate of the left circumflex artery was slower at abnormal LVPWT level than at normal LVPWT level, and that was slower at abnormal Hey level than at normal Hey level.