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Khalil MA, Khalfallah M, Elsheikh A. Predictors and clinical outcomes of slow flow phenomenon in diabetic patients with chronic coronary syndrome. BMC Cardiovasc Disord 2024; 24:518. [PMID: 39333842 PMCID: PMC11430546 DOI: 10.1186/s12872-024-04164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Coronary slow flow (CSF) is characterized by late distal coronary perfusion of coronary arteries at the time of angiography despite the vessels appearing normal. The importance of CSF is still debatable. Therefore, this study aimed to investigate CSF's predictors and clinical outcomes in diabetic patients with chronic coronary syndrome (CCS). PATIENT AND METHODS This retrospective study included 250 diabetic patients diagnosed with chronic stable angina and referred for coronary angiography (CAG), showing normal coronaries with CSF (Group I) and 240 diabetic patients with normal coronaries and normal flow (Group II). The patients in both groups were followed up for one year to evaluate clinical outcomes. RESULTS The incidence of major adverse cardiac events (MACE) was higher in Group I than in Group II, but the difference was not statistically significant except when the composite endpoints of STEMI, NSTEMI, and unstable angina were combined under the term ACS. The independent predictors of CSF, as detected by multivariate regression analysis, were body mass index (BMI) (OR = 0.694, 95% CI = 0.295-0.842, P = 0.010), blood glucose during catheterization (OR = 0.647, 95% CI = 0.298-0.874, P = 0.008), serum triglycerides (OR = 0.574, 95% CI = 0.289-0.746, P = 0.010), and the neutrophil/lymphocyte ratio (NLR) (OR = 0.618, 95% CI = 0.479-0.892, P = 0.001). CONCLUSION Serum triglyceride levels, BMI, NLR, and high blood glucose levels at the time of catheterization were independent predictors of CSF in diabetic patients. MACE levels were higher in diabetic patients with CSF.
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Affiliation(s)
- Mohamed A Khalil
- Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Mohamed Khalfallah
- Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ayman Elsheikh
- Cardiovascular Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Rezaei M, Soltani M, Alipoor E, Rezayat SM, Vasheghani-Farahani A, Yaseri M, Firouzi A, Hosseinzadeh-Attar MJ. Effect of nano-curcumin supplementation on angina status, and traditional and novel cardiovascular risk factors in overweight or obese patients with coronary slow flow phenomenon: a randomized double-blind placebo-controlled clinical trial. BMC Nutr 2024; 10:73. [PMID: 38741194 DOI: 10.1186/s40795-024-00877-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Cardiovascular events and poor quality of life are frequently observed in patients with coronary slow flow phenomenon (CSFP). This trial evaluated the effect of nano-curcumin supplement containing curcuminoids, as multifunctional nutraceuticals, on angina status, and some traditional and novel cardiovascular risk factors in overweight or obese patients with CSFP. METHODS In this double-blind, randomized, placebo-controlled clinical trial, 42 overweight or obese patients with CSFP received either 80 mg/day of nano-curcumin or placebo for 12 weeks. Seattle angina questionnaire (SAQ) as a clinical measure of angina status, circulating endocan, adropin, homocysteine, lipid profile, and the novel scores of visceral adiposity index (VAI) and waist-triglyceride index (WTI) were assessed before and after the intervention. The independent samples t-test, Mann-Whitney test, analysis of covariance, Chi-square, and Fisher's exact tests were used where appropriate. RESULTS All domains of SAQ including physical limitation, angina stability, angina frequency-severity, treatment satisfaction, and disease perception and quality of life improved significantly in the nano-curcumin compared with the placebo group. No significant changes were observed in serum endocan, adropin, and homocysteine following the intervention. Triglycerides, triglyceride/high-density lipoprotein cholesterol ratio, WTI and VAI values improved significantly only within the nano-curcumin group. CONCLUSIONS Supplementation with 80 mg/day nano-curcumin (containing curcuminoids) for 12 weeks significantly improved clinically important disease-specific aspects of health in patients with CSFP. Some traditional and novel cardiovascular risk factors improved significantly only compared with the baseline values, which need further investigation. TRIAL REGISTRATION This study was approved by the Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1398.794). The study protocol was registered at Iranian Registry of Clinical Trials by IRCT20131125015536N8 registration ID at 19.06.2019.
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Affiliation(s)
- Mahsa Rezaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Soltani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Alipoor
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mahdi Rezayat
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nanomedicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Rajaie Cardiovascular, Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Kaplangoray M, Toprak K, Deveci E, Caglayan C, Şahin E. Could Pan-Immune-Inflammation Value be a Marker for the Diagnosis of Coronary Slow Flow Phenomenon? Cardiovasc Toxicol 2024; 24:519-526. [PMID: 38622332 PMCID: PMC11076385 DOI: 10.1007/s12012-024-09855-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
Inflammation plays a key role in the pathogenesis of the coronary slow flow phenomenon (CSFP). The newly developed inflammatory marker, pan-immune-inflammation value (PIV), is associated with adverse cardiovascular events. This study investigated the predictive value of PIV for diagnosing CSFP in comparison to other inflammation-based markers. A total of 214 patients, 109 in the CSFP group and 105 in the normal coronary flow (NCF) group, were retrospectively included in the study. Coronary flow was calculated using the Thrombolysis in Myocardial Infarction frame count method. In addition to PIV, other inflammatory markers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated for the patients. The average age of patients was 50.3 ± 8.4, with a male ratio of 55.1%. Compared to the NCF group, patients in the CSFP group had higher levels of hyperlipidemia, glucose, triglyceride, NLR, PLR, SII, and PIV, while their high-density lipoprotein cholesterol (HDL-C), was lower (p < 0.05). Logistic regression analysis demonstrated that HDL-C, glucose, triglyceride, and PIV were independent predictor factors for CSFP (p < 0.05). PIV is a strong and independent predictor factor for CSFP and superior in predicting CSFP compared to other inflammatory markers.
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Affiliation(s)
- Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medicine, Bilecik Şehy Edebali University, Bilecik, Turkey.
| | - Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Edhem Deveci
- Department of Cardiology, University of Health Sciences, Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, Turkey
| | - Cuneyt Caglayan
- Department of Medical Biochemistry, Faculty of Medicine, Bilecik Şehy Edebali University, Bilecik, Turkey.
| | - Ebru Şahin
- Department of Cardiology, Bilecik Training and Research Hospital, Bilecik, Turkey
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Kaplangoray M, Toprak K, Aydın C, Cekici Y, Yıldırım A, Ozcan Abacıoglu O. The MAPH Score Predicts Coronary Slow Flow. A Retrospective Case-Controlled Study. KARDIOLOGIIA 2024; 64:67-72. [PMID: 38462806 DOI: 10.18087/cardio.2024.2.n2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/25/2022] [Indexed: 03/12/2024]
Abstract
AIM The MAPH score is a new score that combines mean platelet volume (MPV), hematocrit, and total protein, which are markers of whole blood viscosity (WBV). We aimed to investigate the relationship between the MAPH score and the coronary slow flow phenomenon (CSF). MATERIAL AND METHODS A total of 201 patients were included in the study. 105 had CSF and 96 had normal coronary flow (NCF). Coronary flow was measured by the Thrombolysis in Myocardial Infarction frame count (TFC) method. The patients' MPV, age, hematocrit, and total protein were recorded. High (HSR) and low shear rates (LSR) were calculated, based on total protein and hematocrit values. Cut-off values for CSF were determined using the Youden's index, and the score was determined as 0 or 1 according to the cut-off values. The sum of these scores was the MAPH score. RESULTS The mean age of the patients included in the study was 51.1±7.9 (n=201, 54.2 % male). Hyperlipidemia, DM, and HT rates of both groups were similar, but the mean age of the CSF group was higher (p=0.773; p=0.549; p=0.848; p <0.001, respectively). Total protein, MPV, hematocrit, HSR and LSR were higher in the CSF group (p< 0.001, for all values). Comparative receiver operating characteristic (ROC) curve analysis showed that the performance of the MAPH score in predicting CSF is better than the performance of these parameters separately. CONCLUSION A new score, the MAPH score, may be used to identify the presence of CSF.
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Affiliation(s)
| | - Kenan Toprak
- Republic of Turkey Ministry of Health Siverek State Hospital
| | - Cihan Aydın
- Tekirdag Namık Kemal University, Department of Cardiology
| | - Yusuf Cekici
- University of Health Sciences, Adana Health Practice and Research Center
| | - Arafat Yıldırım
- University of Health Sciences, Adana Health Practice and Research Center
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Ipek G, Kamber T, Yilmaz H, Bolca O. Long-Term Change in Flow Rates in Patients with Coronary Slow Flow. Cardiology 2023; 148:500-505. [PMID: 37634497 DOI: 10.1159/000533802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Coronary slow flow (CSF) is a condition characterized by impaired blood flow rates in the coronary arteries. It can result in severe cardiovascular outcomes. There is no sufficient evidence regarding the certain etiology and reversibility of slow flow patterns and changes in frame counts with long-term management. METHODS We retrospectively enrolled 48 patients with chronic coronary syndrome and CSF who underwent a second angiography. A corrected coronary frame rate (CFR) >27 was defined as CSF. We created 3 groups according to the change in CSF status as the improved, not changed, and worsened groups. We compared the CFR and CSF status of the patients between the first and second angiographies within a median of 2.6 years. RESULTS We determined a nonsignificant change in cCFR in left anterior descending (LAD) artery (34.4 [18.9] vs. 31.59 [10.3], p = 0.35), circumflex (Cx) artery (42.84 [12.56] vs. 40.66 [13.2], p = 0.35), and right coronary artery (RCA) (57.80 [30.13] vs. 50.32 [19.5], p = 0.11). In the comparison of CSF status of LAD (75% vs. 63%, p = 0.27), Cx (96% vs. 83%, p = 0.09), RCA (94% vs. 94%, p = 1.0) between first and second angiographies, there was no significant change. In the comparison of the 3 groups according to the improvement of CSF status, there was no significant difference in demographic features, change in laboratory parameters, and time between the groups. CONCLUSION There was no significant change in the median CFR and CSF status in the overall group between the two angiographies after 3 years.
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Affiliation(s)
- Gokturk Ipek
- Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Tugay Kamber
- Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Hale Yilmaz
- Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey
| | - Osman Bolca
- Cardiology Department, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey
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Sánchez-Vinces S, Garcia PHD, Silva AAR, Fernandes AMADP, Barreto JA, Duarte GHB, Antonio MA, Birbrair A, Porcari AM, Carvalho PDO. Mass-Spectrometry-Based Lipidomics Discriminates Specific Changes in Lipid Classes in Healthy and Dyslipidemic Adults. Metabolites 2023; 13:metabo13020222. [PMID: 36837840 PMCID: PMC9964724 DOI: 10.3390/metabo13020222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/31/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
Triacylglycerols (TAGs) and cholesterol lipoprotein levels are widely used to predict cardiovascular risk and metabolic disorders. The aim of this study is to determine how the comprehensive lipidome (individual molecular lipid species) determined by mass spectrometry is correlated to the serum whole-lipidic profile of adults with different lipidemic conditions. The study included samples from 128 adults of both sexes, and they were separated into four groups according to their lipid profile: Group I-normolipidemic (TAG < 150 mg/dL, LDL-C < 160 mg/dL and HDL-c > 40 mg/dL); Group II-isolated hypertriglyceridemia (TAG ≥ 150 mg/dL); Group III-isolated hypercholesterolemia (LDL-C ≥ 160 mg/dL) and Group IV-mixed dyslipidemia. An untargeted mass spectrometry (MS)-based approach was applied to determine the lipidomic signature of 32 healthy and 96 dyslipidemic adults. Limma linear regression was used to predict the correlation of serum TAGs and cholesterol lipoprotein levels with the abundance of the identified MS-annotated lipids found in the subgroups of subjects. Serum TAG levels of dyslipidemic adults have a positive correlation with some of the MS-annotated specific TAGs and ceramides (Cer) and a negative correlation with sphingomyelins (SMs). High-density lipoprotein-cholesterol (HDL-C) levels are positively correlated with some groups of glycerophosphocholine, while low-density lipoprotein-cholesterol (LDL-C) has a positive correlation with SMs.
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Affiliation(s)
- Salvador Sánchez-Vinces
- Health Sciences Postgraduate Program, São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | - Pedro Henrique Dias Garcia
- Health Sciences Postgraduate Program, São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | - Alex Ap. Rosini Silva
- Health Sciences Postgraduate Program, São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | | | - Joyce Aparecida Barreto
- Integrated Unit of Pharmacology and Gastroenterology (UNIFAG), São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | | | - Marcia Aparecida Antonio
- Integrated Unit of Pharmacology and Gastroenterology (UNIFAG), São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | - Alexander Birbrair
- Department of Pathology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53715-1149, USA
- Department of Radiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Andreia M. Porcari
- Health Sciences Postgraduate Program, São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
| | - Patricia de Oliveira Carvalho
- Health Sciences Postgraduate Program, São Francisco University–USF, Bragança Paulista 12900-000, SP, Brazil
- Correspondence: ; Tel.: +55-11-24548298
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Dai XT, Kong TZ, Zhang XJ, Luan B, Wang Y, Hou AJ. Relationship between increased systemic immune-inflammation index and coronary slow flow phenomenon. BMC Cardiovasc Disord 2022; 22:362. [PMID: 35941535 PMCID: PMC9358856 DOI: 10.1186/s12872-022-02798-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio), a new marker of inflammation, is associated with adverse cardiovascular events, but its relationship with coronary slow flow phenomenon (CSFP) is unclear. Therefore, we aimed to investigate the relationship between SII and CSFP. Methods We enrolled consecutive patients who presented with chest pain, with normal/near-normal coronary angiography findings (n = 89 as CSFP group; n = 167 as control group). The baseline characteristics, laboratory parameters and angiographic characteristics of the two groups were compared. Results SII levels were significantly higher in the CSFP group than in the control group (409.7 ± 17.7 vs. 396.7 ± 12.7, p < 0.001). A significant positive correlation between SII and the mean thrombolysis in myocardial infarction frame count (mTFC) was found (r = 0.624, p < 0.001). SII increased with the number of coronary arteries involved in CSFP. In multivariate logistic regression analysis, SII/10 was an independent predictor of CSFP (odds ratio: 1.739, p < 0.001). In addition, the SII level > 404.29 was a predictor of CSFP with 67.4% sensitivity and 71.9% specificity. Conclusions SII can predict the occurrence of CSFP.
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Affiliation(s)
- Xin-Tong Dai
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Tian-Zhong Kong
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Xiao-Jiao Zhang
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Bo Luan
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Yong Wang
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China.
| | - Ai-Jie Hou
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China.
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