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Analysis of correlative factors of female coronary slow-flow phenomenon: A retrospective study
Xin Chen1, Alian Zhang, Zuojun Xu
1Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Insights
This study identifies unique risk factors for coronary slow-flow phenomenon (CSFP) in women, including smoking, elevated free fatty acids (FFA), and lower free thyroxine (FT4) levels. These findings highlight important differences in CSFP development among female patients.
Area of Science:
- Cardiology
- Vascular Biology
- Endocrinology
Background:
- Coronary slow-flow phenomenon (CSFP) is characterized by delayed coronary blood flow without significant stenosis.
- CSFP predominantly affects male patients, prompting investigation into distinct risk factors in females.
- Understanding female-specific CSFP risk factors is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To identify distinct clinical and biochemical risk factors associated with CSFP in female patients.
- To compare these factors between female CSFP patients and a control group with normal coronary arteries.
- To determine independent predictors of CSFP in this population.
Main Methods:
- A single-center retrospective study involving 92 female CSFP patients and 92 controls.
- Coronary angiography was used for CSFP diagnosis.
- Comparative analysis of clinical data, lipid profiles, and thyroid hormone levels.
Main Results:
- CSFP patients showed higher rates of smoking, diabetes mellitus, and elevated total cholesterol and free fatty acids (FFA).
- Lower levels of apolipoprotein E (ApoE), free thyroxine (FT4), and total thyroxine (TT4) were observed in the CSFP group.
- Smoking, FFA, ApoE, and FT4 were identified as independent risk factors for CSFP.
Conclusions:
- Female CSFP patients present with distinct risk factor profiles compared to the general population.
- Smoking, elevated FFA, and altered thyroid hormone levels (specifically lower FT4) are significant independent risk factors for CSFP in women.
- These findings underscore the need for tailored risk assessment and management of CSFP in female patients.
Abstract:
The coronary slow-flow phenomenon (CSFP) is a manifestation of coronary artery disease wherein coronary angiography reveals no apparent stenosis; however, there is a delay in blood flow perfusion. Given its increased occurrence in male patients, with the majority of subjects in previous studies being male, this study aimed to explore whether distinct risk factors are present in female patients with CSFP. This single-center retrospective study focused on female patients diagnosed with CSFP by using coronary angiography. Eligible patients meeting the predefined inclusion and exclusion criteria were divided into the study group (presenting with CSFP) and control group (displaying normal epicardial coronary arteries). Comparative analyses of clinical and diagnostic data were performed. Ninety-two patients with CSFP and an equal number of controls were enrolled in this study. Patients with CSFP exhibited a higher prevalence of smokers (P = .017) and a heightened incidence of diabetes mellitus (DM) (P = .007). Significantly elevated levels of total cholesterol (TC) (P = .034) and free fatty acids (FFA) (P = .016) were observed in the CSFP group compared to those in the control group. Additionally, patients with CSFP displayed lower levels of apolipoprotein E (ApoE) (P = .092), free thyroxine (FT4) (P = .001), and total thyroxine (TT4) (P = .025). Logistic regression analysis indicated that smoking (P = .019), FFA (P < .001), ApoE (P = .015), and FT4 (P < .001) were independent risk factors for CSFP, accounting for confounding factors. Additionally, the area under the ROC curve (AUC) of the combined effect of smoking, ApoE, FT4, and FFA on CSFP was 0.793 (95% CI: 0.729-0.857, P < .01). In addition to the established risk factors for smoking, diabetes, and hyperlipidemia, female patients with CSFP exhibited significant differences in apoE, FFA, FT4, and TT4 levels compared to the control group. Smoking, FFA, and FT4 levels emerged as independent risk factors for CSFP.
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