Accuracy of Fibrinogen/D-dimer Ratio in Predicting the Occurrence of Coronary Slow Flow Phenomenon
DOI:
https://doi.org/10.3889/oamjms.2020.5542Keywords:
Fibrinogen, D-dimer, Acute coronary syndrome, Heart diseaseAbstract
BACKGROUND: Fibrinogen is a risk factor for coronary heart disease (CHD), which is an acute-phase protein that is released when inflammation occurs. Fibrinogen is an essential component in the coagulation cascade and affects hemostasis, hemorheology, platelet aggregation, and endothelial function. D-dimers are inevitable products of fibrin degradation that results from thrombin activation; XIII activated factors and plasmin.
AIM: This study was aimed to explore the accuracy of the fibrinogen/D-dimer ratio in predicting the slow flow phenomenon in CHD.
METHODS: The study design is a diagnostic test with a cross-sectional design to assess the accuracy of the fibrinogen/d-dimer ratio in predicting coronary slow flow phenomenon (CSFP) in CHD. The study was conducted at the Department of Internal Medicine, Faculty of Medicine, Dr. Moh Hoesin Hospital, Palembang, Indonesia. The independent variables in this study were serum fibrinogen and D-dimer levels. Meanwhile, the dependent variable is sufferers of CHD with CSFP and regular flow. All data obtained from this study were analyzed using the SPSS version 20.0 for Windows program with a 95% confidence limit.
RESULTS: This study showed that there was no difference in levels of fibrinogen and D-dimer in groups with CSFP and regular flow. Fibrinogen and D-dimer do not play a significant role in the CSFP process. The various etiological parts of this possible disorder still need further exploration and detail, ranging from the role of the renin-angiotensin-aldosterone system, the function of the autonomic nervous system, to the position of other endothelial factors.
CONCLUSION: This study proves that fibrinogen has specific but not sensitive predictors of CSFP. The d-dimer value is also not accurate as a CSFP predictor. This study demonstrates that the fibrinogen / d-dimer ratio is not precise as a predictor of CSFP events.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Bauer T, Zeymer U, Diallo A, Vicaut E, Bolognese L, Cequier A, et al. Impact of preprocedural TIMI flow on clinical outcome in low-risk patients with ST-elevation myocardial infarction: Results from the Atlantic study. Catheter Cardiovasc Interv. 2020;95(3):494-500. https://doi.org/10.1002/ccd.28318 PMid:31067010 DOI: https://doi.org/10.1002/ccd.28318
Fineschi M, Bravi A, Gori T. The slow coronary flow phenomenon: Evidence of preserved coronary flow reserve despite increased resting microvascular resistances. Int J Cardiol. 2008;127(3):358- 61. https://doi.org/10.1016/j.ijcard.2007.06.010 PMid:17651842 DOI: https://doi.org/10.1016/j.ijcard.2007.06.010
Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon-a new coronary microvascular disorder. Cardiology. 2002;97(4):197-202. https://doi.org/10.1159/000063121 PMid:12145474 DOI: https://doi.org/10.1159/000063121
Sezgin AT, Sigirci A, Barutcu I, Topal E, Sezgin N, Ozdemir R, et al. Vascular endothelial function in patients with slow coronary flow. Coron Artery Dis. 2003;14(2):155-61. https://doi.org/10.1097/00019501-200304000-00008 PMid:12655279 DOI: https://doi.org/10.1097/00019501-200304000-00008
Tripodi A. D-dimer testing in laboratory practice. Clin Chem. 2011;57(9):1256-62. PMid:21719689 DOI: https://doi.org/10.1373/clinchem.2011.166249
Hochuli M, Duewell S, Frauchiger B. Quantitative d-dimer levels and the extent of venous thromboembolism in CT angiography and lower limb ultrasonography. Vasa. 2007;36(4):267-74. https://doi.org/10.1024/0301-1526.36.4.267 PMid:18357919 DOI: https://doi.org/10.1024/0301-1526.36.4.267
Li JJ, Zheng X, Li J. Statins may be beneficial for patients with slow coronary flow syndrome due to its anti-inflamatory property. Med Hypotheses. 2007;69(2):333-7. https://doi.org/10.1016/j.mehy.2006.09.070 PMid:17215087 DOI: https://doi.org/10.1016/j.mehy.2006.09.070
Simsel H, Sahin M, Gunes Y, Akdag S, Akil MA. A novel echocardiographic method as an indicator of endothelial dysfunction in patients with coronary slow flow. Eur Rev Med Pharmacol Sci. 2013;17(5):689-93. PMid:23543453
Mangieri E, Macchiarelli G, Ciavolella M. Slow coronary flow: Clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet Cardiovasc Diagn. 1996;37(4):375-81. https://doi.org/10.1002/(sici)1097-0304(199604)37:4<375::aid-ccd7>3.0.co;2-8 PMid:8721694 DOI: https://doi.org/10.1002/(SICI)1097-0304(199604)37:4<375::AID-CCD7>3.0.CO;2-8
Seyyed-Mohammadzad MH, Rashtchizadeh S, Khademvatani K, Afsargharehbagh R, Nasiri A, Sepehrvand N. Ventricular dysfunction in patients with coronary slow-flow phenomenon: A single-center case-control study. Heart Views. 2020;21(2):60-4. https://doi.org/10.4103/heartviews.heartviews_119_18 PMid:33014297 DOI: https://doi.org/10.4103/HEARTVIEWS.HEARTVIEWS_119_18
Wang Y, Ma C, Zhang Y, Guan Z, Liu S, Li Y, et al. Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking echocardiography in patients with coronary slow-flow phenomenon. PLoS One. 2015;10(2):e0117979. https://doi.org/10.1371/journal.pone.0117979 PMid:25706989 DOI: https://doi.org/10.1371/journal.pone.0117979
Gulel O, Akcay M, Soylu K, Aksan G, Yuksel S, Zengin H, et al. Left ventricular myocardial deformation parameters are affected by coronary slow flow phenomenon: A study of speckle tracking echocardiography. Echocardiography. 2016;33(5):714-23. https://doi.org/10.1111/echo.13146 PMid:26668075 DOI: https://doi.org/10.1111/echo.13146
Demirkol MO, Yaymaci B, Mutlu B. Dipyridamole myocardial perfusion single photon emission computed tomography in patients with slow coronary flow. Coron Artery Dis. 2002;13:223- 9. https://doi.org/10.1097/00019501-200206000-00004 PMid:12193849 DOI: https://doi.org/10.1097/00019501-200206000-00004
TIMI Study Group. The thrombolysis in myocardial infarction (TIMI) trial. Phase I findings. N Engl J Med. 1985;312(14):932- 6. https://doi.org/10.1056/nejm198504043121437 PMid:4038784 DOI: https://doi.org/10.1056/NEJM198504043121437
Stone GW. PAMI (primary angioplasty in myocardial infarction) stent pilot trial. Clin Cardiol. 1998;21(2):130. https://doi.org/10.1002/clc.4960210216 PMid:9491956 DOI: https://doi.org/10.1002/clc.4960210216
Sanati H, Kiani R, Shakerian F, Firouzi A, Zahedmehr A, Peighambari M, et al. Coronary slow flow phenomenon: Clinical findings and predictors. Res Cardiovasc Med. 2016;5(1):e30296. https://doi.org/10.4103/2251-9572.218699 PMid:26889458 DOI: https://doi.org/10.5812/cardiovascmed.30296
Chaudhry MA, Smith M, Hanna EB, Laazzara R. Diverse spectrum of presentation of coronary slow flow phenomenon: A concise review of the literature. Cardiol Res Pract. 2012;2012:383181. PMid:22645695 DOI: https://doi.org/10.1155/2012/383181
Singh S, Kothari SS, Bahl VK. Coronary slow flow phenomenon: An angiographic curiosity. Indian Heart J. 2004;56(6):613-7. PMid:15751515
Duncker DJ, Bache RJ. Regulation of coronary blood flow during exercise. Physiol Rev. 2008;88(3):1009-86. https://doi.org/10.1152/physrev.00045.2006 PMid:18626066 DOI: https://doi.org/10.1152/physrev.00045.2006
Hawkins BM, Savrakis S, Rousan TA, Abu-Fadel M, Schecter E. Coronary slow flow prevalence and clinical correlations. Circ J. 2012;76(4):936-42. https://doi.org/10.1253/circj.cj-11-0959 PMid:22293446 DOI: https://doi.org/10.1253/circj.CJ-11-0959
Yilmaz H, Demir I, Uyar Z. Clinical and coronary angiographic characteristics of patients with coronary slow flow. Acta Cardiol. 2008;63(5):579-84. https://doi.org/10.2143/ac.63.5.2033224 PMid:19014000 DOI: https://doi.org/10.2143/AC.63.5.2033224
Arbel Y, Rind E, Banai S, Halkin A, Berliner S, Herz I, et al. Prevalence and predictors of slow flow in angiographically normal coronary arteries. Clin Hemorheol Microcirc. 2012;52(1):5-14. https://doi.org/10.3233/ch-2012-1538 PMid:22387483 DOI: https://doi.org/10.3233/CH-2012-1538
Alvarez C, Siu H. Coronary slow flow phenomenon as an underrecognized and treatable source of chest pain: case series and literature review. J Investig Med High Impact Case Rep. 2018;6:2324709618789194. https://doi.org/10.1177/2324709618789194 DOI: https://doi.org/10.1177/2324709618789194
Wang Y, Li Y, Liu S, Mu L, Li G, Yu H, et al. Value of exercise stress electrocardiography for stratification of exercise capacity and left ventricular systolic and diastolic function on coronary slow flow: Case-control study. BMC Cardiovasc Disord. 2019;19(1):288. https://doi.org/10.1186/s12872-019-01291-5 PMid:31830922 DOI: https://doi.org/10.1186/s12872-019-01291-5
Gibson CM, Ryan KA, Kelley M. Methodologic drift in the assessment of TIMI grade 3 flow and its implications with respect to the reporting of angiographic trial results. The TIMI Study Group. Am Heart J. 1999; 137:1179-84. https://dx.doi.org/10.1016/s0002-8703(99)70380-7 DOI: https://doi.org/10.1016/S0002-8703(99)70380-7
Gibson CM, Cannon CP, Daley WL. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996; 93:879-88. https://dx.doi.org/10.1161/01.cir.93.5.879 DOI: https://doi.org/10.1161/01.CIR.93.5.879
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2020 Taufik Indrajaya, Alie Ghanie, Andi Arman (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
