Statins may be beneficial for patients with slow coronary flow syndrome due to its anti-inflammatory property

Med Hypotheses. 2007;69(2):333-7. doi: 10.1016/j.mehy.2006.09.070. Epub 2007 Jan 9.

Abstract

The phenomenon of slow progression of angiographic contrast in the coronary arteries in the absence of stenosis in the epicardial vessels in some patients presenting with chest pain has been recently called as slow coronary flow syndrome because the underlying pathophysiological mechanisms as well as therapeutics of this unique phenomenon is less well understood. Although this phenomenon was first reported on in 1972 by Tambe, few studies have focused on the etiology of this unique angiographic finding since that time. Several hypotheses have been poised to elucidate this phenomenon, including a form of early phase of atherosclerosis, small vessel dysfunction, Hagen-Poiseuille's equation model, imbalance between vasoconstrictor and vasodilatory factors, and platelet function disorder. During the last several years there has been arisen the most interesting concept of "atherosclerosis as a inflammation disease", which is involving the different entities of coronary artery disease covering slow coronary flow syndrome. The angiographic finding appeared as slow flow is an important clinical entity because it may be the cause of angina at rest or during exercise, acute myocardial infarction, and hypertension. Despite the good prognosis, patients complained commonly of persistent uncomfortable chest, which can significantly impair quality of life. There is no effective therapy for patients with slow coronary flow syndrome up to now. Statins have been showed the important benefits for the large populations of individuals at high risk of coronary artery disease. In addition to lowering lipid profile, statins have pleiotropic effects on improving vascular function. Increasing evidence, suggests that reduction of cardiovascular events conferred by statins relates not only to cholesterol lowering but also to direct effects on endothelium function as well as anti-thrombotic and anti-inflammatory actions. Accordingly, we hypotheses that these pleiotropic effects of statin may be beneficial for patients with slow coronary flow syndrome due to its pharmacological basis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / physiopathology*
  • Coronary Circulation / drug effects*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Syndrome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors