The Relationship Between Serum Uric Acidconcentrations And Coronary Slow Flow Phenomenon

Background: Coronary slow flow phenomenon(CSFP) is characterized by delayed pacification in epicedial coronary arteries.CSFP can lead to angina, myocardial ischemia and sudden cardiac death, thus people gradually attaches great importance to it. But the pathophysiology is not established, a mount of studies suggest that CSFP may be associated with endothelial dysfunction, atherosclerosis and inflammation of epicardial coronary arteries and microvascular.Studies have shown that uric acid is an independent biochemical index of atherosclerosis, oxidative stress and endothelial dysfunction. But its correlation with slow coronary flow(SCF) is still unclear. This study proposed to explore the relationship between SCF and uric acid through Thrombolysis In Myocardial Infarction frame count(TFC) and other laboratory parameters. Methods: In this retrospective study, from January 2013 to June 2014 we involved a total of 62 patients as CSF group who undergone coronary angiography(CAG) in Fujian Medical University Union Hospital because of angina symptoms such as chest tightness or chest pain, the CAG showed epicedial coronary arteries with no significant lesions but with coronary slow flow. During the same period involved a total of 68 patients with the CAG confirmed epicedial coronary artery completely normal and normal coronary flow as the control group, normal coronary flow group(NCF group).We respectively recorded TIMI frame count(TFC) in these two group, recorded the basic clinical data of all observed, measured and recorded the laboratory indexes such as lipid metabolism and biochemical. Then use t-test and Chi-square test to comparing the difference between the two groups of patients with the clinical data. The associations between SCF and all parameters were analyzed by Pearson’s correlation and Logistic regression analysis. Results: The clinical characteristics and laboratory parameters of SCF patients and control subjects are presented in Table1,No marked differences in the gender, age,body mass index, heart rate, blood pressure. The risk factors of coronary heart disease such as hypertension and diabetes were not significant.Labortory laboratory indexes such as homocysteine,fibrinogen, white blood cell count, platelet count,creatinine level were not significantly different. Patients with SCF had higher TIMI frame count(TFC) in all of the major epicedial coronary arteries than control subjects(P<0.001).Serum uric acid level and hypersensitive C-reactive protein( hsCRP) level of SCF group were significantly higher than those in NCF group( respectively400±118umol/L VS 263.5±76umol/L, P<0.001; 1.505±1.52mg/L VS 0.145±2.26mg/L, P<0.001)。The mean TFC was positively correlated with serum uric acid and hs-CRP level(respectively r=0.555,P<0.001 and r=0.238,P=0.006)assessed by the Pearson correlation test. Through the single factor analysis we found that cigarette smoking, alcohol consumption, increased uric acid level and hs-CRP level were risk factors of SCF.Through multivariate logistic stepwise regression analysis, we found that uric acid level and hs-CRP level were the independent predictor of SCF(respectively OR = 1.022, 95% CI 1.041 to 1.031, P < 0.001 and OR=1.126,95%CI 1.027-1.032,P<0.001). Conclusions:1.SCF group have higher serum uric acid level and hs-CRP level.2. The mean TFC was positively correlated with serum uric acid and hs-CRP level,and that elevated uric acid and hs-CRP level might be independent predictors for the presence of SCF.3.Inflammation may play a critical role in the pathophysiological mechanism of SCF.