Long-TERM clinical outcome results in coronary slow flow pati̇ents

Coronary slow-flow phenomenon(CSF), characterized by delayed distal vein opacification with the absence of important epicardial coronary disease. It has clinical importance because of causing chest pain during resting and exercise. CSF is detected in %1-4 of patients who applied coronary angiography. Even though high catheterization rates and hospitalization due to chest pain of patients with coronary slow-flow, medical prognosis is known to be good same as normal population. There are not so many studies about this field. There are studies about disease etiology and treatment rather than patient follow-up. Underway, although it seems to be caused by etiologic factors such as high microvascular resistance and extensive coronary atherosclerosis, pathophysiological mechanism of this phenomenon is not fully revealed. CSF, could be defined as local disease of coronary arteries. In addition to this, frequent togetherness with more common vascular anomaly is an another characteristic of coronary slow-flow. Clinical course is characterized by significantly impaired quality of life because of frequent chest pains. Even though there are so many studies on coronary slow-flow, it hasn't been reached a consensus about its, diagnosis criterias, treatment, follow-up and clinical significance. The long term follow up of patients and clinical results of this study can contribute the managment of diesease in the first application and follow-up. Also it could form a new perspective for clinicans. Patients who has applied to Başkent University Adana Md. Turgut Noyan Research And Application Hospital on May 2004 - May 2008 with complaints of stable angina or unstable angina pectoris(USAP), which left main coronary arter disease and significant stenosis in other three major coronary arter and minors above 2.0 mm excluded with coronary angiography and patients with normal coronary artery are included in this study. With scanning old archive files, totally 112 conscutive coronary slow flow patients were chosen from 11.156 patients and included to the study. For reasons such as exclusion criteria, communication deficiency, record problems this number has decreased to 50 patients. Chosen patients were reached by phone and required informations were recorded. Coronary slow-flow group consist of 38 male (%76) and 12 female (%24), normal coronary arter group consist of 26 male (%52) and 24 female(%48). The avarage age of the coronary slow-flow group was 60,9 + 6,3 years and the normal coronary arter group was 56,4 + 8,7 years. By comparison with normal coronary patients, rates of subsequently recurring urgent application, subsequently made and positive eventuated effort test, subsequently continuing angina pain complaints, ischemic ECG change during application and continuing dyspneic complaints were higher in coronary slow-flow patients. This differences was statistically significant. Later developed and diagnosed peripheral arterial disease was more frequent in CSF group. For the first time in our study, long-term outcomes of CSF patients were compared. For the first time, peripheral artery disease has been found more frequent in CSF patients (%8 vs %0, p:0,059). For the first time mortality rates found higher in CSF patients (%6 vs %3, p:0.243). Larger patient capacity studies are needed to confirm this thesis.