Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China.
Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
BMC Cardiovasc Disord. 2020 May 27;20(1):248. doi: 10.1186/s12872-020-01463-8.
Coronary slow flow (CSF) is characterized by delayed opacification of distal epicardial coronary arteries without significant coronary stenosis. In addition, The changes of lipoprotein-associated phospholipase A2 (Lp-PLA) as a significant predictive factor for CSF remain controversial. The study aims to investigate the association between plasma Lp-PLA and CSF.
In this retrospective study, 170 consecutive patients who underwent coronary angiography were enrolled in Beijing Anzhen Hospital from January 2017 to September 2019, and were divided into CSF group and normal control groups. According to coronary blood flow rate measured by the thrombolysis in myocardial infarction frame count (TFC) method, CSF was defined as TFC > 27. Serum Lp-PLA levels were measured in an enzyme-linked immunosorbent assay.
Lp-PLA levels were higher in the CSF group than in the control group (288.6 ± 50.3 versus 141.9 ± 49.7, P < 0.001) and were significantly correlated with the mean coronary artery thrombolysis in myocardial infarction (TIMI) frame count (r = 0.790, P<0.001). Logistic regression analysis showed that high Lp-PLA was independently associated with CSF after adjustment for conventional risk factors (OR = 1.040, CI = 1.022-1.059, P<0.001). Male sex (OR = 2.192, CI = 1.161-4.140, P = 0.016) and hypertension (OR = 1.965, CI = 1.034-3.736, P = 0.039) were also CSF risk factors. Receiver-operating characteristic curve (ROC) analysis showed that Lp-PLA levels can predict CSF severity; the predictive power was higher than the other risk factors.
Our study demonstrated that patients with CSF had higher circulating levels of Lp-PLA than normal controls. After adjustment for potential confounders, increased Lp-PLA was independently associated with presence of CSF.
冠状动脉慢血流（CSF）的特征是心外膜冠状动脉远端显影延迟，而无明显冠状动脉狭窄。此外，脂蛋白相关磷脂酶 A2（Lp-PLA）作为 CSF 的一个重要预测因子的变化仍存在争议。本研究旨在探讨血浆 Lp-PLA 与 CSF 之间的关系。
本回顾性研究纳入了 2017 年 1 月至 2019 年 9 月在北京安贞医院接受冠状动脉造影的 170 例连续患者，并将其分为 CSF 组和正常对照组。根据心肌梗死溶栓帧数（TFC）法测量的冠状动脉血流速度，将 CSF 定义为 TFC>27。采用酶联免疫吸附试验测定血清 Lp-PLA 水平。
CSF 组 Lp-PLA 水平高于对照组（288.6±50.3 比 141.9±49.7，P<0.001），且与平均冠状动脉 TIMI 帧数呈显著正相关（r=0.790，P<0.001）。多因素 logistic 回归分析显示，在校正传统危险因素后，高 Lp-PLA 与 CSF 独立相关（OR=1.040，CI=1.022-1.059，P<0.001）。男性（OR=2.192，CI=1.161-4.140，P=0.016）和高血压（OR=1.965，CI=1.034-3.736，P=0.039）也是 CSF 的危险因素。受试者工作特征曲线（ROC）分析表明，Lp-PLA 水平可以预测 CSF 的严重程度；其预测能力高于其他危险因素。
本研究表明，CSF 患者的循环 Lp-PLA 水平高于正常对照组。在校正潜在混杂因素后，Lp-PLA 水平升高与 CSF 的存在独立相关。
