Turk Kardiyol Dern Ars. Ahead of Print: TKDA-82258 | DOI: 10.5543/tkda.2019.82258
The coronary slow flow phenomenon and microalbuminuria; is there any relation?
, Rosa Ghaderpanah1
, Elham Rayzan2
, Arya Aminorroaya2
, Masih Tajdini11
Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran2
Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Universal Scientific Education and Research Network (USERN), Tehran, Iran
OBJECTIVE Pathophysiology of coronary slow flow phenomenon (CSFP) is poorly understood. Evidence suggesting endothelial dysfunction in patients with slow coronary flow (SCF) encouraged us to evaluate the possible correlation of microalbuminuria (MAU), as an indicator of endothelial dysfunction, and CSFP in order to clarify a mutual pathophysiology.
METHODS In this case-control study, 15786 patients were screened between September 2016 and April 2018. All of them had chest pain and were indicated to undergo coronary angiography due to a positive non-invasive test. Cases were patients with TIMI-2 flow grade or corrected TIMI frame count of more than 27, without any evidence of obstructive coronary artery disease. Controls had completely normal coronary angiograms. Patients mid-stream fasting urines were analyzed by the immunoturbidimetric assay to determine the albumin-creatinine ratio (ACR) as a surrogate of MAU (ACR of 30 to 300 mg/g). The prevalence of MAU has been compared in the case and the control groups.
RESULTS One hundred-fifty-four individuals with a normal coronary angiogram and 46 patients with SCF were enrolled based on our inclusion and exclusion criteria. Prevalence of MAU was greater in patients with SCF rather than the control group (8.7% vs 1.9%, respectively, P=0.048). Even after adjustment for important factors, the association between MAU and CSPF was remained significant.
CONCLUSION Our study indicated association of MAU with CSFP and confirmed endothelial dysfunction as a contributing factor to CSFP. This finding is of utmost importance due to the prognostic value of MAU on both all-cause and cardiovascular mortality rates.
Coronary Slow Flow Phenomenon, Coronary Slow Flow, Microalbuminuria, Endothelial Dysfunction
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Corresponding Author: Masih Tajdini, Iran