| Objective:The purpose of this study was to explore the pathophysiological mechanism of Hs-CRP/Albumin(CAR)and Cystatin C(CysC),which are highly hot serum biomarkers,in Coronary Slow Flow(CSF)and their predictive value for CSF.Method:We identified patients with chest pain who were underwent coronary angiography(CAG)from June 2018 to December 2019 in The Affiliated Hospital of Qingdao University;83 patients showed features of CSF and 108 patients showed normal coronary arteries blood flow(NCF)in comparison.The differences in clinical indicators between the two groups were compared,logistic regression was used to analyze independent risk factors of CSF and the diagnostic value of CAR and CysC for CSF was evaluated by the receiver operating characteristic curve(ROC).P < 0.05 was considered to be statistically significant.Results:1 The proportion of males in the CSF group was significantly higher than that in the NCF group(P < 0.05).There was no significant difference in age,smoking history,hypertension,and diabetes between the two groups(P > 0.05).2 Serum Hs-CRP,CAR and CysC levels in the CSF group were significantly higher than those in the control group,while Alb levels were significantly lower than those in NCF group.There were no significant differences in other serum biomarkers between groups(P > 0.05).3 Logistic regression results showed that male,CAR and CysC were independent risk factors that affected CSF.4 The area under the ROC curve of CAR predicting for CSF was 0.715.When the cutoff value was set at 0.06,the Youden index reached the maximum with a sensitivity of85.50% and a specificity of 62.00%.The area under the ROC curve of CysC was 0.719,when the cutoff value was set at 1.15,with a sensitivity of 33.73% and a specificity of99.07%.However,for gender,the area under the ROC curve was 0.586,the corresponding sensitivity was 54.22%,and the specificity was 62.96% which is not effective for the diagnosis of CSF.5 In the CSF group,the majority of patients showed coronary slow flow in two vessels(n=39,47%),followed by single vessels(n=26,31.3%)and finally three vessels(n=18,21.7%).The vascular localization of CSF was most common in LAD(n=61,73.5%),followed by LCX(n= 55,66.3%),and finally RCA(n=42,48.2%).6 Spearman correlation analysis showed that the serum CAR and CysC levels were positively correlated with the number of vessels affected by CSF(r >0,P < 0.05).Conclusion:1 Male and serum CAR and CysC levels were independent risk factors for CSF.Serum CAR and CysC levels were positively correlated with the number of vessels affected by CSF.2 Inflammation,endothelial dysfunction,microvascular dysfunction,and early coronary atherosclerosis may play an important role in the pathogenesis of CSF.The lesions of CSF were mainly manifested in the involvement of two coronary arteries.The vascular localization of CSF was more common in LAD and LCX.3 Serum CAR and CysC can be used as important serum biomarkers to predict CSF. |
