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Association Between Orthostatic Hypotension With Coronary Slow Flow in Patients With Chest Pain: A Single Center
Lijun Han1, Meng Li1, Wenting Xie1
1Department of cardiology and macrovascular disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Orthostatic hypotension (OH) is linked to coronary slow flow (CSF) in patients with normal coronary arteries. This study identifies OH as an independent risk factor for CSF, suggesting its predictive value.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Markers
Background:
- Orthostatic hypotension (OH) is a known complication of various cardiovascular diseases.
- The relationship between OH and coronary slow flow (CSF) has not been previously investigated.
- CSF is characterized by delayed transit of contrast media through the coronary arteries despite normal epicardial coronary angiography.
Purpose of the Study:
- To investigate the association between orthostatic hypotension (OH) and coronary slow flow (CSF) in patients presenting with chest pain and normal coronary arteries.
- To determine if OH is an independent predictor of CSF in this patient population.
Main Methods:
- Retrospective analysis of 655 patients with normal coronary arteries who underwent coronary angiography (CAG) between January 2022 and August 2023.
- Patients were categorized into CSF (n=69) and normal blood flow (NBF) (n=586) groups.
- Logistic regression analyses (uni-variable and multi-variable) were employed to assess the association between OH and CSF, controlling for other clinical and laboratory variables.
Main Results:
- Uni-variable analysis identified several risk factors for CSF, including higher body weight index, faster heart rate, chronic kidney disease, absence of antidiabetic therapy, and elevated levels of various biomarkers (AST, uric acid, triglycerides, total cholesterol, ApoB1, LDL-C, homocysteine, BNP), alongside OH.
- Multi-variable logistic regression confirmed that OH is an independent risk factor for predicting CSF.
- The study found OH to be significantly associated with the presence of CSF in patients with normal coronary arteries.
Conclusions:
- Orthostatic hypotension (OH) may serve as a valuable predictor for coronary slow flow (CSF) in patients experiencing chest pain but exhibiting normal coronary arteries on angiography.
- Further research is warranted to elucidate the underlying mechanisms connecting OH and CSF.
Background:
Orthostatic hypotension (OH) is associated with different cardiovascular diseases, however, the association between OH and coronary slow flow (CSF) has never been evaluated before.
Materials And Methods:
Chest pain patients who underwent coronary angiography (CAG) and with normal coronary arteries in our department from January 1st, 2022 to August 31st, 2023 were retrospectively enrolled. Patients were divided into the CSF group and the normal blood flow (NBF) group. Relative clinical information, laboratory test results as well as the results of CAG were collected and analyzed. Both uni-variable and multi-variable logistic regression analyses were used to evaluate the association between OH and CSF in these patients.
Results:
Four thousand six hundred and twenty-seven patients underwent CAG and 655 patients had normal coronary arteries. In which, sixty-nine patients were diagnosed with CSF while 586 patients were diagnosed with NBF. Uni-variable analysis revealed that higher body weight index, faster heart rate in sitting position, accompanied with chronic kidney disease, did not take Antidiabetic therapy, higher level of aspartate transaminase, uric acid, triglyceride, total cholesterol, ApoB1, low-density lipoprotein cholesterol, homocysteine, B-type natriuretic peptide as well as OH are the risk factors for CSF in these patients. Multi-variable logistic regressing analysis further demonstrated that OH was the independent risk factor for predicting CSF in these patients.
Conclusions:
Our finding suggests OH might be a useful predictor for CSF in patients with chest pain but normal coronary arteries.
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