İsa SİNCER, Yusuf ÇEKİCİ, Arafat YILDIRIM, Mustafa KAPLANGORAY, Mücahid YILMAZ

Does serum uric acid to high-density lipoprotein cholesterol ratio predict coronary slow flow?

Aim: Several studies have found a correlation between coronary slow flow (CSF) and low serum high-density lipoprotein cholesterol (HDL-C) levels or high serum uric acid levels. The present study aimed to evaluate whether serum uric acid to HDL-C ratio predicts CSF.Material and Methods: The experimental (CSF) group included 91 patients (40 females, 51 males, mean age: 52±9) who had angiographically normal coronary arteries but had slow flow in one or more coronary arteries. The control group included 96 patients (57 females, 39 males, mean age: 50±9) with normal coronary anatomy and without slow flow. The uric acid to HDL-C ratio was calculated for the two groups and compared.Results: The HDL-C levels of the CSF group (37±8 mg/dL) were significantly lower compared to the controls (49±10 mg/dL, p

PDF

___

1. Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon–a new coronary microvascular disorder. Cardiology 2002;97:197-202.
2. Wang X, Nie S-P. The coronary slow flow phenomenon: characteristics, mechanisms and implications. Cardiovasc Diag Ther 2011;1:37.
3. Sezgin AT, Sgrc A, Barutcu I, et al. Vascular endothelial function in patients with slow coronary flow. Coron Artery Dis 2003;14:155-61.
4. Camsari A, Ozcan T, Ozer C, et al. Carotid artery intima-media thickness correlates with intravascular ultrasound parameters in patients with slow coronary flow. Atherosclerosis 2008;200:310-4.
5. Xu Y, Meng H-L, Su Y-M et al. Serum YKL-40 is increased in patients with slow coronary flow. Coron Artery Dis 2015;26:121-5.
6. Barutcu I, Sezgin AT, Sezgin N et al. Increased high sensitive CRP level and its significance in pathogenesis of slow coronary flow. Angiology 2007;58:401-7.
7. Selcuk H, Selcuk MT, Temizhan A et al. Decreased plasma concentrations of adiponectin in patients with slow coronary flow. Heart Vessels 2009;24:1.
8. Capuano V, Marchese F, Capuano R, et al. Hyperuricemia as an independent risk factor for major cardiovascular events: a 10-year cohort study from Southern Italy. J Cardiovasc Med 2017;18:159-64.
9. Wu LL, Wu JT. Serum uric acid is a marker of inflammation and a marker predicting the risk of developing CVD, stroke, renal failure and cancer. J Biomed Lab Sci 2008;20:1-6.
10. Kanellis J, Kang D-H. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol: Elsevier, 2005:39-42.
11. Sanati H, Kiani R, Shakerian F et al. Coronary slow flow phenomenon clinical findings and predictors. Res Cardiovas Med 2016;5.
12. Kocak MZ, Aktas G, Erkus E, et al. Serum uric acid to HDL-cholesterol ratio is a strong predictor of metabolic syndrome in type 2 diabetes mellitus. Rev Assoc Méd Bras 2019;65:9-15.
13. Gibson CM, Cannon CP, Daley WL et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88.
14. Borghi C, Rodriguez-Artalejo F, Guy De Backer, et al. Serum uric acid levels are associated with cardiovascular risk score: a post hoc analysis of the EURIKA study. Int J cardiol 2018;253:167-73.
15. Wang R, Song Y, Yan Y, et al. Elevated serum uric acid and risk of cardiovascular or all-cause mortality in people with suspected or definite coronary artery disease: a meta-analysis. Atherosclerosis 2016;254:193-9.
16. Kuwabara M, Hisatome I, Niwa K et al.Uric acid is a strong risk marker for developing hypertension from prehypertension: a 5-year Japanese cohort study. Hypertension 2018;71:78-86.
17. Yu TY, Jee JH, Bae JC, et al. Serum uric acid: a strong and independent predictor of metabolic syndrome after adjusting for body composition. Metabolism 2016;65:432-40.
18. Biscaglia S, Ceconi C, Malagù M, et al. Uric acid and coronary artery disease: an elusive link deserving further attention. Int J Cardiol 2016;213:28-32.
19. Zhang X, Huang Z-C, Lu T-S, et al. Prognostic significance of uric acid levels in ischemic stroke patients. Neurotox Res 2016;29:10-20.
20. Erdogan D, Caliskan M, Gullu H, et al. Coronary flow reserve is impaired in patients with slow coronary flow. Atherosclerosis 2007;191:168-74.
21. Sezgin N, Barutcu I, Sezgin AT, et al. Plasma nitric oxide level and its role in slow coronary flow phenomenon. Int Heart J 2005;46:373-82.
22. Pekdemir H, Cicek D, Camsari A, et al. The relationship between plasma endotheli-1, nitric oxide levels, and heart rate variability in patients with coronary slow flow. Ann Noninvasive Electrocardiol 2004;9:24-33.
23. Lim DH, Lee Y, Park GM, et al. Serum uric acid level and subclinical coronary atherosclerosis in asymptomatic individuals: An observational cohort study. Atherosclerosis 2019;288:112-7.
24. Li JJ, Qin XW, Li ZC, et al. Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow. Clinica Chimica Acta 2007;385:43-7.
25. Turhan H, Saydam GS, Erbay AR, et al. Increased plasma soluble adhesion molecules; ICAM-1, VCAM- 1, and E-selectin levels in patients with slow coronary flow. Int J Cardiol 2006;108:224-30.
26. Mazidi M, Katsiki N, Mikhailidis DP, et al. Association of ideal cardiovascular health metrics with serum uric acid, inflammation and atherogenic index of plasma: A population-based survey. Atherosclerosis 2019;284:44-9.
27. Mosseri M, Yarom R, Gotsman M, et al. Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries. Circulation 1986;74:964-72.
28. Kanbay M, Sánchez-Lozada LG, Franco M, et al. Microvascular disease and its role in the brain and cardiovascular system: a potential role for uric acid as a cardiorenal toxin. Nephrol Dial Transplant 2011;26:430-7.
29. Cin VG, Pekdemir H, Camsar A, et al. Diffuse intimal thickening of coronary arteries in slow coronary flow. Jpn Heart J 2003;44:907-19.
30. Gersch C, Palii SP, Kim KM, et al. Inactivation of nitric oxide by uric acid. Nucleosides, Nucleotides Nucleic Acids 2008;27:967-78.
31. Spiga R, Marini MA, Mancuso E, et al. Uric acid is associated with inflammatory biomarkers and induces inflammation via activating the NF-κB signaling pathway in HepG2 cells. Arterioscler Thromb Vasc Biol 2017;37:1241-9.
32. Quinones Galvan A, Natali A, Baldi S, et al. Effect of insulin on uric acid excretion in humans. Am J Physiol- Endocrinol Metab 1995;268:1-5.
33. Xia S, Deng SB, Wang Y, et al. Clinical analysis of the risk factors of slow coronary flow. Heart Vessels 2011;26:480-6.
34. Kaya EB, Yorgun H, Canpolat U, et al. Serum uric acid levels predict the severity and morphology of coronary atherosclerosis detected by multidetector computed tomography. Atherosclerosis 2010;213:178-183.
35. Hawkins BM, Stavrakis S, Rousan TA, et al. Coronary slow flow. Circulation Journal 2012;76:936-42.
36. Naing Z, Qiu CG. Dawn of the most influential mechanism from the nightmare of slow coronary flow phenomenon: a randomized controlled study. Int J Cardiol 2013;168:4951-3,