Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
J Cardiol. 2014 Feb;63(2):112-8. doi: 10.1016/j.jjcc.2013.07.010. Epub 2013 Sep 4.
Endothelial dysfunction may play a role in the pathogenesis of the slow coronary flow (SCF) phenomenon. A detailed examination of blood cellular components has not been performed for this condition. We investigated the relationship between SCF and whole blood cell counts.
Records of 17,315 patients who underwent coronary angiography between January 2006 and December 2012 were evaluated retrospectively. A total of 146 patients with SCF were compared with 148 patients with normal coronary arteries according to demographic data, complete blood count, and biochemical parameters.
The following parameters were significantly higher in SCF patients than in patients with normal coronary arteries: percentage of smokers (36.3% vs. 25%, p=0.036), body mass index (26.69 ± 2.84 vs. 26.07 ± 3.15, p=0.049), white blood cells (WBCs) (7.52 ± 1.43 × 10(3)mm(-3) vs. 7.01 ± 1.42 × 10(3)mm(-3), p=0.002), red cell distribution width (RDW) (13.68 ± 1.42% vs. 13.15 ± 1.13%, p<0.001), platelets (250.29 ± 50.96 × 10(3)mm(-3) vs. 226.10 ± 38.02 × 10(3)mm(-3), p<0.001), plateletcrit (PCT) (0.214 ± 0.40% vs. 0.184 ±0.29%, p<0.001), mean platelet volume (8.63 ± 1.10fL vs. 8.22 ± 0.83 fL, p<0.001), platelet distribution width (PDW) (16.58 ± 0.76% vs. 16.45 ± 0.57%, p=0.028), and neutrophils (4.44 ± 1.25 × 10(3)mm(-3) vs. 4.12 ± 1.24 × 10(3)mm(-3), p=0.029). Positive PCT values [odds ratio (OR), 4.165; 95% confidence interval (CI), 2.493-6.959; p<0.001) and RDW (OR, 1.304; 95% CI, 1.034-1.645; p=0.025) were independent predictors of SCF.
Although within the normal range, the increased numbers of WBCs and neutrophils in patients with SCF suggest that SCF may be a subclinical inflammatory condition. Furthermore, increased RDW and PDW in SCF patients may cause microvascular blood flow resistance due to impaired cell deformability. The PCT provides reliable data regarding total platelet mass and may be a useful predictor of SCF.
内皮功能障碍可能在慢血流（SCF）现象的发病机制中起作用。尚未对这种情况的血液细胞成分进行详细检查。我们研究了 SCF 与全血细胞计数之间的关系。
回顾性评估了 2006 年 1 月至 2012 年 12 月间进行冠状动脉造影的 17315 例患者的记录。根据人口统计学数据、全血细胞计数和生化参数，将 146 例 SCF 患者与 148 例冠状动脉正常的患者进行比较。
与冠状动脉正常的患者相比，SCF 患者的以下参数明显更高：吸烟者的百分比（36.3%比 25%，p=0.036）、体重指数（26.69 ± 2.84 比 26.07 ± 3.15，p=0.049）、白细胞（7.52 ± 1.43×103mm-3比 7.01 ± 1.42×103mm-3，p=0.002）、红细胞分布宽度（RDW）（13.68 ± 1.42%比 13.15 ± 1.13%，p<0.001）、血小板（250.29 ± 50.96×103mm-3比 226.10 ± 38.02×103mm-3，p<0.001）、血小板压积（PCT）（0.214 ± 0.40%比 0.184 ±0.29%，p<0.001）、平均血小板体积（8.63 ± 1.10fL 比 8.22 ± 0.83 fL，p<0.001）、血小板分布宽度（PDW）（16.58 ± 0.76%比 16.45 ± 0.57%，p=0.028）和中性粒细胞（4.44 ± 1.25×103mm-3比 4.12 ± 1.24×103mm-3，p=0.029）。阳性 PCT 值（比值比[OR]，4.165；95%置信区间[CI]，2.493-6.959；p<0.001）和 RDW（OR，1.304；95%CI，1.034-1.645；p=0.025）是 SCF 的独立预测因子。
尽管在正常范围内，但 SCF 患者白细胞和中性粒细胞数量的增加表明 SCF 可能是一种亚临床炎症状态。此外，SCF 患者的 RDW 和 PDW 增加可能会由于细胞变形能力受损而导致微血管血流阻力增加。PCT 提供了有关总血小板质量的可靠数据，可能是 SCF 的有用预测指标。
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