Association of Lymphocyte-to-Monocyte Ratio, Mean Diameter of Coronary Arteries, Uric Acid with Coronary Slow Flow in Isolated Coronary Artery Ectasia

Abstract Background The pathophysiology of isolated coronary artery ectasia (CAE) with coronary slow flow (CSF) phenomenon is still unclear. The purpose of this study was to investigate the risk factors for isolated CAE complicated with CSF.Methods A total of 126 patients with isolated CAE were selected retrospectively. The patients were grouped into the no CSF(NCSF) group (n=55) and CSF group (n=71) according to the thrombolysis in myocardial infarction (TIMI) frame count (TFC). Data on demographics, laboratory measurements, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), TFC and diameters of three coronary arteries were collected.Results The proportion of patients with male sex(84.5% vs 61.8%, p=0.004) and a smoking history(63.4% vs 43.6%, p=0.021) in the CSF group were greater than that in the NCSF group. The neutrophil-to-lymphocyte ratio (NLR)(2.44±1.12 vs 1.89±0.58, p=0.001), mean diameter of coronary arteries (Mean D)(5.50±0.85 vs 5.18±0.91, p<0.001), and uric acid (URIC) level(370.78±109.79 vs 329.15±79.71, p=0.019) were significantly higher in the CSF group, while the lymphocyte-to-monocyte ratio (LMR)(4.81±1.66 vs 5.96±1.75, p<0.001) and albumin (ALB)(44.13±4.10 vs 45.69±4.11, p=0.036) level were lower. Multivariable logistic analysis showed that the LMR(odds ratio: 0.614, 95%CI:0.464-0.814, p=0.001), Mean D(odds ratio: 2.643, 95%CI: 1.54-4.51,p<0.001) and URIC(odds ratio: 1.006, 95%CI:1.001-1.012, p=0.018) level were independent predictors of CSFP in CAE. The predictive power of this combination was superior to URIC and Mean D but not superior to the LMR.Conclusions The LMR, URIC level and Mean D were independent predictors of CSF in isolated CAE. The predictive power of the LMR was not inferior to the combination of predictors.