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International Journal of Cardiology Sciences

Vol. 6, Issue 1, Part A (2024)

Biochemical and hematological predictors of coronary slow flow

Author(s):

Amr Elsaied Elnagar, Abdelrahman Gamal Abdelsalam, Mohamed Reda Sonbol, Saad Mahmoud Ammar and Karim Elakabawi

Abstract:

Background: Coronary slow-flow phenomenon (CSFP), without presence of obstructive coronary artery disease, can be defined by delayed distal vessel opacification angiographically. We aimed to assess the biochemical and haematological predictors of CSF in cases with stable angina or angina-like symptoms with a focus on baseline risk factors, high-sensitive Troponin, alkaline phosphatase, lipid profile, random blood sugar, C reactive protein, complete blood count, QT interval measurement on surface ECG, and systolic and diastolic functions by echocardiography. 
Patients and Methods: This case-control research was conducted on 100 consecutive cases of CSFP aged from 25 to 80 years old and 100 age and sex-matched control cases with normal coronaries. All patients underwent laboratory investigations, electrocardiograms, and echocardiography.
Results: On multiple regression analysis, Lymphocyte count, MCV, TG HDL ratio, PLR, NLR, and ALP were significant predictors of CSFP. Lymphocyte count can significantly predict CSFP with an AUC of 0.943, P value of < 0.001, and a cutoff value ≤1.42 x109 with 89% sensitivity, 81% specificity, 82.4% PPV and 88% NPV. Lymphocyte to monocyte ratio can significantly predict CSFP with an AUC of 0.834, P value of < 0.001, and a cutoff value ≤3.64 with 77% sensitivity, 73% specificity, 74% PPV and 76% NPV. NLR can significantly predict CSFP with an AUC of 0.878, P value of < 0.001, and a cutoff value >2.69 with 78% sensitivity, 76% specificity, 76.5% PPV and 77.6% NPV. PLR can significantly predict CSFP with an AUC of 0.936, P value of < 0.001, and a cutoff value >213.67 with 88% sensitivity, 88% specificity, 88% PPV and 88% NPV. We observed that Hb, hematocrit, monocyte count, Neutrophil count, PLT, albumin, ALP, CRP, Fibrinogen, total cholesterol, HDL, LDL, and TG-HDL ratio, showed low sensitivity and specificity values with insignificant AUC.
Conclusion: The Lymphocyte count, MCV, TG HDL ratio, PLR, NLR, and ALP were independent predictors of CSFP. Whereas Hb, hematocrit, monocyte count, Neutrophil count, PLT, albumin, ALP, CRP, Fibrinogen, total cholesterol, HDL, LDL, TG-HDL ratio, showed low sensitivity and specificity values.

Pages: 67-73  |  81 Views  22 Downloads


International Journal of Cardiology Sciences
How to cite this article:
Amr Elsaied Elnagar, Abdelrahman Gamal Abdelsalam, Mohamed Reda Sonbol, Saad Mahmoud Ammar and Karim Elakabawi. Biochemical and hematological predictors of coronary slow flow. Int. J. Cardiol. Sci. 2024;6(1):67-73. DOI: 10.33545/26649020.2024.v6.i1a.52