Evaluation of Plasma Thrombomodulin in Patients with Coronary Slow Flow

Cardiology ◽  
2017 ◽  
Vol 138 (3) ◽  
pp. 141-146 ◽  
Author(s):  
Yong Wang ◽  
Peng-yu Jia ◽  
Bao-jun Chen ◽  
Yan Chen ◽  
Hang Yu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Endothelial Dysfunction ◽  
Coronary Flow ◽  
Linear Regression Analysis ◽  
High Plasma ◽  
Control Group ◽  
Slow Flow ◽  
Distribution Width ◽  
Timi Frame Count ◽  
Coronary Slow Flow

Background: It has been reported that coronary slow flow (CSF) is associated with acute myocardial infarction, ventricular tachycardia, ventricular fibrillation, and even sudden cardiac death. Although studies concerning the etiopathogenesis of CSF are scarce, diffuse atherosclerosis and endothelial dysfunction are thought to play important roles. It has been suggested that a high plasma thrombomodulin (TM) level seems to play an important role in the pathogenesis of atherosclerosis and endothelial dysfunction. Objectives: We hypothesized that a high plasma TM level might be associated with CSF and aimed to research the relationship between plasma TM level and CSF. Methods: Fifty-two CSF patients with angiographically proven CSF and 44 cases with normal coronary flow were included in this study. Coronary flow velocity was determined by the thrombolysis in myocardial infarction (TIMI) frame count method. Plasma TM levels were measured in all the study subjects. Results: Plasma TM levels were significantly higher in the CSF group compared to the control group (3.9 ± 0.5 vs. 3.6 ± 0.3 ng/mL, p = 0.01). There was a positive relationship (r = 0.31, p = 0.002) between plasma TM level and mean TIMI frame count (TFC). Factors associated with mean TFC were plasma TM level (β = 0.206, p = 0.038) and red cell distribution width (β = 0.088, p = 0.009) in multiple linear regression analysis. Conclusions: Patients with CSF have a higher plasma TM level, and this may play an important role in the pathogenesis of CSF. An elevated plasma TM level may be a predictor of CSF. Future studies are needed to confirm these results.

scholarly journals Evolution of Coronary Flow in an Experimental Slow Flow Model in Swines: Angiographic and Pathological Insights

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Yupeng Bai ◽  
Liqun Hu ◽  
Delong Yu ◽  
Sheng Peng ◽  
Xiaogang Liu ◽  
...  
Keyword(s):  
Coronary Flow ◽  
Flow Model ◽  
Left Ventricular ◽  
Control Group ◽  
Large Animal ◽  
Slow Flow ◽  
Pathological Changes ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

Objective. Pathomechanism of coronary slow flow phenomenon remains largely unclear now. Present study observed the pathological and angiographic evolution in a pig model of coronary slow flow.Methods. Coronary slow flow was induced by repeat coronary injection of small doses of 40 µm microspheres in 18 male domestic pigs and angiographic and pathological changes were determined at 3 hours, 7 days, and 28 days after microspheres injection.Results. Compared to control group treated with coronary saline injectionn=6and baseline level, coronary flow was significantly reduced at 3 hours and 7 days but completely recovered at 28 days after coronary microsphere injection in slow flow group. Despite normal coronary flow at 28 days after microsphere injection, enhanced myocardial cytokine expression, left ventricular dysfunction, adverse remodelling, and ischemia/microembolism related pathological changes still persisted or even progressed from 3 hours to 28 days after coronary microsphere injection.Conclusions. Our results show that this large animal slow flow model could partly reflect the chronic angiographic, hemodynamic, and pathological changes of coronary slow flow and could be used to test new therapy strategies against the slow flow phenomenon.

scholarly journals Predictors of Coronary Slow Flow Phenomenon: A Retrospective Study

2019 ◽  
Vol 04 (02) ◽  
pp. 085-091
Author(s):  
Satish Kumar Rao V. ◽  
Indrani Garre
Keyword(s):  
Risk Factors ◽  
Uric Acid ◽  
Total Cholesterol ◽  
Inflammatory Markers ◽  
Coronary Flow ◽  
Control Group ◽  
Slow Flow ◽  
Lymphocyte Ratio ◽  
Coronary Slow Flow ◽  
Hs Crp

Abstract Aim This study aimed to analyze laboratory predictors, angiographic profile, clinical profile, and risk factors for coronary slow flow (CSF) phenomenon without coronary obstructive lesion in patients who came for a coronary angiogram. Materials and Methods The case-control study consisted of patients who underwent coronary angiography and were divided into two groups: patients with coronary slow flow (case group, n = 100) and patients with the normal coronary flow (control group, n = 100). Coronary flow was studied using corrected thrombolysis in myocardial infarction frame count (CTFC). The slow flow was defined as CTFC beyond 2 standard deviations from the normal published range. Risk factors including age, sex, diabetes mellitus (DM), hypertension, dyslipidemia, smoking, body mass index (BMI), hematological and biochemical parameters (complete blood picture, platelet count, total and differential leucocyte count, platelet-to-lymphocyte ratio [PLR], neutrophil-to-lymphocyte ratio [NLR] and lipid profile) were assessed. In both groups, clinical information was collected, and laboratory parameters were measured and compared. Results Patients with CSF were more likely to be male and active smokers. Total cholesterol, triglyceride, BMI, and DM were more commonly seen in the CSF group compared with the control group. Inflammatory markers like uric acid (p = 0.03) and high-sensitivity C-reactive protein (Hs-CRP) (p = 0.000) were found to be statistically significant. Hematocrit (p = 0.023), NLR (p = 0.001), total cholesterol (p = 0.000), triglycerides (p = 0.000), and BMI (p = 0.000) were statistically significant. PLR has the tendency of statistically significance (p = 0.059) BMI, total cholesterol, triglycerides, and Hs-CRP were strong predictors for CSF. Conclusion CSF was common in males, smokers, DM patients, and it was associated with high NLR, uric acid, and Hs-CRP levels. The independent predictor of CSF was BMI, total cholesterol, triglycerides, and Hs-CRP levels. These findings provide an impetus for additional studies to confirm the role of other inflammatory markers in CSF patients and treatment strategies depending on that.

scholarly journals miRNA-22 as a Candidate Diagnostic Biomarker for Coronary Slow Flow

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tong Chen ◽  
Zhen-Yu Wang ◽  
Chuan-Chang Li
Keyword(s):  
Coronary Angiography ◽  
Early Diagnosis ◽  
Roc Curve ◽  
Coronary Flow ◽  
Control Group ◽  
Slow Flow ◽  
Diagnostic Efficiency ◽  
Serum Mirna ◽  
Potential Biomarker ◽  
Coronary Slow Flow

Background. Coronary slow flow (CSF) refers to the phenomenon of delayed distal flow in the absence of lesions detected on coronary angiography. Although the detection rate of CSF has been increasing in clinical practice, early diagnosis is difficult and the factors contributing to this condition remain unclear. Given the increasing demonstration of the roles of microRNAs (miRNAs) in disease and as diagnostic biomarkers, the aim of this study was to analyze the expression of serum miRNA-22 in patients with CSF detected using coronary angiography and its diagnostic efficacy. Methods and Results. A retrospective analysis including 44 patients with CSF and 42 patients with normal coronary flow (control group) was conducted. Additionally, all included patients either did not have visually estimated coronary artery stenosis or had <50% stenosis. Plasma samples were collected from patients in these two groups, and the levels of miRNA-22 were detected. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of serum miRNA-22 in the context of CSF. Results. The expression of serum miRNA-22 was significantly higher in the CSF patients than in the control subjects (P < 0.0001). The area under the ROC curve for miRNA-22 in diagnosing CSF was 0.8293 (95% confidence interval: 0.7313–0.9272), with a sensitivity of 75.0% and specificity of 88.1%. Conclusions. The expression of serum miRNA-22 in CSF is upregulated compared to that in subjects with normal coronary flow and shows relatively high clinical diagnostic efficiency, suggesting a new potential biomarker for the early diagnosis of CSF.

scholarly journals Relationship Between the Reciprocal Change in Inflammation-Related Biomarkers (Fibrinogen-to-Albumin and hsCRP-to-Albumin Ratios) and the Presence and Severity of Coronary Slow Flow

2019 ◽  
Vol 25 ◽  
pp. 107602961983538 ◽  
Author(s):  
Osman Kayapinar ◽  
Cem Ozde ◽  
Adnan Kaya
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Stable Coronary Artery Disease ◽  
Albumin Level ◽  
Control Group ◽  
Slow Flow ◽  
Characteristic Analysis ◽  
Normal Coronary Arteries ◽  
Coronary Slow Flow ◽  
Reciprocal Change

Inflammation has been implicated in the pathogenesis of endothelial dysfunction, atherosclerosis, and microvascular coronary dysfunction. In this context, it is thought that fibrinogen, high-sensitive C-reactive protein (hsCRP), and albumin may be associated with the pathogenesis of coronary slow flow (CSF). We aimed to evaluate the ratios of fibrinogen-to-albumin and hsCRP-to-albumin in patients with CSF compared to patients with angiographically normal coronary arteries and stable coronary artery disease (CAD). In all, 65 patients with CSF, 65 patients with newly diagnosed stable CAD, and 65 control participants with angiographically normal coronary arteries were included. The coronary flow rates of all patients were determined by the Thrombolysis in Myocardial Infarction frame count method. Fibrinogen, hsCRP, and albumin levels were analyzed in all patients, and the fibrinogen-to-albumin and hsCRP-to-albumin ratios were calculated. The baseline characteristics of the 3 groups were similar. The plasma albumin level was significantly lower, whereas the fibrinogen and the hsCRP levels were significantly higher, in the CSF and CAD groups compared to the controls. The fibrinogen-to-albumin and hsCRP-to-albumin ratios were significantly higher in both the CSF and the CAD groups compared to the control group. The hsCRP-to-albumin ratio was positively correlated with the mean Thrombolysis in Myocardial Infarction frame count in the whole study population. According to the receiver–operating characteristic analysis, the efficacies of the fibrinogen-to-albumin and hsCRP-to-albumin ratios in predicting CSF were significant. The fibrinogen-to-albumin and hsCRP-to-albumin ratios, which were increased by a reciprocal change, suggest that inflammation may play a role in the pathogenesis of CSF.

scholarly journals Circulating miRNA-155 as a Potential Biomarker for Coronary Slow Flow

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Qiang Su ◽  
Huafeng Yang ◽  
Lang Li
Keyword(s):  
Confidence Interval ◽  
Plasma Levels ◽  
Coronary Flow ◽  
Control Group ◽  
Multivariate Linear Regression Analysis ◽  
Slow Flow ◽  
Potential Biomarker ◽  
Coronary Slow Flow ◽  
Hs Crp ◽  
Plasma Mirna

Objective. Recent studies have demonstrated that miRNA-155 is involved in the occurrence and development of atherosclerosis. Furthermore, miRNA-155 has emerged as a new indirect marker for inflammation associated with adverse outcomes in oncology and cardiovascular diseases. This study investigated the correlation between the levels of miRNA-155 and coronary slow flow (CSF). Methods. A total of 66 patients with CSF and 66 patients with normal coronary flow were enrolled in this study. Coronary flow velocity was determined using the thrombolysis in myocardial infarction frame count (TFC) method. The plasma levels of miRNA-155 were quantified using real-time quantitative polymerase chain reaction. Results. The plasma levels of miRNA-155 were significantly higher in the CSF group compared to the control group (P<0.05). In addition, miRNA-155 levels were positively correlated with TFC and high-sensitivity C-reactive protein (hs-CRP) levels (P<0.05 for both parameters). Multivariate linear regression analysis demonstrated that plasma miRNA-155 (OR = 2.384, 95% confidence interval 1.847–3.273, P=0.032) and hs-CRP (OR = 1.273, 95% confidence interval 1.036–2.253, P=0.013) were independent predictors for CSF. Using plasma miRNA-155 levels as the test variable, ROC curve analysis indicated that the area under the curve was 0.782 (P<0.05). Conclusion. Patients with CSF have higher plasma levels of miRNA-155, and this may play an important role in the pathogenesis of CSF, and an elevated plasma miRNA-155 level may be a predictor for CSF. A large-scale and multicenter study is required to elucidate the role of miRNA-155 as a potential biomarker for patients with CSF.

scholarly journals Assessment of Coronary Slow Flow, Cystatin C, and Body Mass Index in Female Candidates for Diagnostic Coronary Artery Angiography

2020 ◽  
Vol 5 (1) ◽  
pp. 4-8
Author(s):  
Naser Aslan Abadi ◽  
Roghaiyeh Afsargharehbagh ◽  
Aliakbar Nasiri ◽  
MirHosein SeyedMohammadzad ◽  
Kamal Khademvatan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cystatin C ◽  
Pearson Correlation ◽  
Enzyme Linked Immunosorbent Assay ◽  
Slow Flow ◽  
Significance Level ◽  
Timi Frame Count ◽  
Female Patients ◽  
Coronary Slow Flow

Introduction: Evidence indicates that the associations between coronary slow flow (CSF), cystatin C (Cys C), and body mass index (BMI) are unclear. Therefore, the purpose of our study was to determine the association among the above-mentioned parameters in female patients. Methods: This was a descriptive-analytical study and the participants were those who were referred to the Shohada Cardiovascular Center of Urmia in 2015-2016. The participants were measured by a quantitative method under angiography (corrected TIMI frame count, CTFC) for CSF assessment, followed by evaluating physiological indices and the serum Cys C by the enzyme-linked immunosorbent assay. Finally, Pearson correlation coefficient test was used to analyze the correlations among CTFC, Cys C, and BMI, and a significance level of P < 0.05 was used for this test. Results: Sixty-six female patients (mean age: 57.01±8.25 years) took part in this study. The correlations among Cys C with CTFC, and BMI (r=-0.189, P=0.128 and r=0.044, P=0.724, respectively) and BMI with CTFC (r=-0.178, P=0.153) were not meaningful in female patients’ who were candidates for angiography. Conclusion: In general, the results suggested that serum Cys C cannot be considered as a predictive biomarker for the prognostic stratification of CSF and BMI in female patients aged 34-73 years who were candidates for angiography.

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