• advanced lung cancer inflammation index
• angina and nonobstructive coronary arteries
• coronary slow flow phenomenon
• predictor

• funding

• Neutrophil percentage-to-albumin ratio
• Predictors
• Slow coronary flow phenomenon

• Humans
• Male
• Neutrophils
• Female
• Middle Aged
• No-Reflow Phenomenon/blood
• No-Reflow Phenomenon/physiopathology
• No-Reflow Phenomenon/diagnostic imaging
• No-Reflow Phenomenon/diagnosis
• Predictive Value of Tests
• Coronary Angiography
• Aged
• Coronary Circulation
• Serum Albumin, Human/analysis
• Biomarkers/blood
• Case-Control Studies
• Leukocyte Count
• Blood Flow Velocity
• Retrospective Studies
• Risk Factors
• Serum Albumin/analysis

• Chest pain
• Coronary slow flow phenomenon
• Inflammatory burden index
• No obstructive coronary arteries
• Predictors

• Humans
• Male
• Female
• Middle Aged
• Coronary Circulation
• Predictive Value of Tests
• C-Reactive Protein/metabolism
• C-Reactive Protein/analysis
• No-Reflow Phenomenon/physiopathology
• No-Reflow Phenomenon/blood
• No-Reflow Phenomenon/diagnosis
• No-Reflow Phenomenon/diagnostic imaging
• No-Reflow Phenomenon/etiology
• Case-Control Studies
• Coronary Angiography
• Biomarkers/blood
• Risk Factors
• Inflammation Mediators/blood
• Inflammation/physiopathology
• Inflammation/diagnosis
• Inflammation/blood
• Aged
• Lymphocyte Count
• Adult
• Neutrophils
• Coronary Vessels/physiopathology
• Coronary Vessels/diagnostic imaging
• Angina Pectoris/physiopathology
• Angina Pectoris/blood
• Angina Pectoris/diagnosis
• Angina Pectoris/diagnostic imaging

• coronary slow flow phenomenon
• myocardial ischemia with no obstructive coronary arteries
• neutrophil percentage-to-albumin ratio
• predictors

• There is no funding to report

• albumin
• coronary microcirculation
• dynamic single‐photon emission tomography (SPECT)
• myocardial flow reserve (MFR)
• myocardial perfusion imaging (MPI)

• Humans
• Male
• Female
• Aged
• Middle Aged
• Retrospective Studies
• Zinc/blood
• Cadmium/blood
• Tellurium
• Coronary Circulation
• Tomography, Emission-Computed, Single-Photon
• Microcirculation
• Myocardial Perfusion Imaging/methods
• Heart Failure/physiopathology
• Heart Failure/blood
• Heart Failure/diagnostic imaging
• Zinc Compounds
• Serum Albumin

• Ministry of Science and Technology, Taiwan
• Far Eastern Memorial Hospital

A total of 197 patients (102 patients with CSF; 95 patients with normal coronary flow) were included in this retrospective study. Clinical and angiographic characteristics of patients were obtained from hospital records.

Patients with CSF had higher SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), and high-sensitivity C-reactive protein (hsCRP) levels compared with the control group. Body mass index (p=0.022, OR 1.151, 95% CI 1.121–1.299), low-density lipoprotein (p=0.018, OR 1.028, 95% CI 1.005–1.052), hsCRP (p=0.044, OR 1.161, 95% CI 1.004–1.343), and SII (p < 0.001, OR 1.015, 95% CI 1.003–1.026) were independent predictors of CSF in the multivariable analysis. The optimal cutoff value of SII in predicting CSF was >877 in ROC curve analysis (p < 0.001, AUC = 0.892, 95% CI 0.848–0.936). This cutoff value of SII predicted the CSF with a sensitivity of 71.5% and specificity of 92.4%. Spearman correlation analysis showed a positive correlation between the mean TFC value and PLR, NLR, hsCRP, and SII.

SII may be used as a better indicator for the prediction of CSF than hsCRP.

Background: Coronary slow flow (CSF) is a common cardiovascular phenomenon with no effective treatment in conventional Western medicine (CWM). Shexiang Baoxin Pill (SXBXP) is a widely used Chinese medicine for cardiovascular disease in China, and clinical studies have shown that it has good efficacy for CSF.

Objective: To systematically evaluate the efficacy and safety of SXBXP for CSF.

Methods: Seven databases were searched to identify related randomized controlled trials (RCTs). The Meta-analysis, trial sequential analysis (TSA), and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) were performed using Stata 14.1, TSA 0.9.5.10 Beta and GRADE profiler 3.2.2 software respectively.

Results: A total of 10 RCTs were included. Meta-analysis showed that compared with CWM treatment alone, SXBXP combined with CWM further improved the angina pectoris efficacy [RR = 1.37, 95% CI (1.23, 1.52), p < 0.000 01] and nitric oxide (NO) level [WMD = 11.32, 95% CI (0.04, 22.59), p = 0.049], decreased the mean corrected TIMI frame count (CTFC) [WMD = −4.23, 95% CI (−5.51, −2.95), p < 0.000 01], CTFC of the left anterior descending artery (LAD) [WMD = −6.36, 95% CI (−12.07, −0.65), p = 0.029], left circumflex artery (LCX) [WMD = -5.73, 95% CI (−8.79, −2.67), p < 0.000 01], and right coronary artery (RCA) [WMD = −6.72, 95% CI (−10.60, −2.84), p = 0.001], decreased the positive rate of treadmill exercise test [RR = 0.45, 95% CI (0.25, 0.83), p = 0.010], endothelin-1 (ET-1) level [WMD = -11.03, 95% CI (−13.92, −8.14), p < 0.000 01], high-sensitivity C-reactive protein (hs-CRP) [WMD = −1.95, 95% CI (−2.57, −1.34), p < 0.000 01], and adverse reactions [RR = 0.20, 95% CI (0.05, 0.85), p = 0.030]. The GRADE evidence quality rating presented with moderate, low or very low quality of evidence. TSA further affirmed the clinical efficacy.

Conclusion: Although some results suggest that there may be a positive effect of SXBXP for CSF, the quality of the primary study including the reporting is too poor and therefore, no benefits could be demonstrated. More high-quality studies are still needed to further confirm the efficacy and safety.

Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022329469).

The pathophysiology of isolated coronary artery ectasia (CAE) with the 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.

A total of 126 patients with isolated CAE were selected retrospectively. The patients were grouped into the no CSF (NCSF) group (n = 55) and the CSF group (n = 71) according to the corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC). Data on demographics, laboratory measurements, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), CTFC and diameters of three coronary arteries were collected.

The proportions of males (84.5% vs. 61.8%, p = 0.004) and patients with a smoking history (63.4% vs. 43.6%, p = 0.021) were higher in the CSF group than in the NCSF group. The neutrophil-to-lymphocyte ratio (NLR) (2.08(1.68–3.21) 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) level (44.13 ± 4.10 vs. 45.69 ± 4.11, p = 0.036) 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 level (odds ratio: 1.006, 95% CI: 1.001–1.012, p = 0.018) were independent predictors of CSF in CAE.

The LMR was a negative independent predictor of CSF in isolated CAE, while URIC level and mean D were positive independent predictors.

• Coronary slow flow
• Isolated coronary artery ectasia
• Lymphocyte-to-monocyte ratio
• Mean diameter of arteries
• Uric acid

• Chronic kidney diseases
• Dental prosthesis
• Hemodialysis
• Malnutrition

Inflammation has been implicated in the pathogenesis of endothelial dysfunction, atherosclerosis, and microvascular coronary dysfunction. In this context, it is thought that fibrinogen, high-sensitive C-reactive protein (hsCRP), and albumin may be associated with the pathogenesis of coronary slow flow (CSF). We aimed to evaluate the ratios of fibrinogen-to-albumin and hsCRP-to-albumin in patients with CSF compared to patients with angiographically normal coronary arteries and stable coronary artery disease (CAD). In all, 65 patients with CSF, 65 patients with newly diagnosed stable CAD, and 65 control participants with angiographically normal coronary arteries were included. The coronary flow rates of all patients were determined by the Thrombolysis in Myocardial Infarction frame count method. Fibrinogen, hsCRP, and albumin levels were analyzed in all patients, and the fibrinogen-to-albumin and hsCRP-to-albumin ratios were calculated. The baseline characteristics of the 3 groups were similar. The plasma albumin level was significantly lower, whereas the fibrinogen and the hsCRP levels were significantly higher, in the CSF and CAD groups compared to the controls. The fibrinogen-to-albumin and hsCRP-to-albumin ratios were significantly higher in both the CSF and the CAD groups compared to the control group. The hsCRP-to-albumin ratio was positively correlated with the mean Thrombolysis in Myocardial Infarction frame count in the whole study population. According to the receiver–operating characteristic analysis, the efficacies of the fibrinogen-to-albumin and hsCRP-to-albumin ratios in predicting CSF were significant. The fibrinogen-to-albumin and hsCRP-to-albumin ratios, which were increased by a reciprocal change, suggest that inflammation may play a role in the pathogenesis of CSF.

• coronary slow flow
• fibrinogen-to-albumin ratio
• hsCRP-to-albumin ratio

To evaluate the incidence, etiology, and predictors of mortality of severe hypoxic hepatitis.

We used computerized patient records to identify consecutive cases of severe hypoxic hepatitis admitted to a tertiary hospital in Singapore over a one-year period. We defined severe hypoxic hepatitis as elevation of serum transaminases more than 100 times upper limit of normal in the clinical setting of cardiac, circulatory or respiratory failure after exclusion of other causes of hepatitis. We used multivariable regression analysis to determine predictors for mortality.

We identified 75 cases of severe hypoxic hepatitis out of 71380 hospital admissions over one year, providing an incidence of 1.05 cases per 1000 admissions. Median age was 65 years (range 19-88); 57.3% males. The most common etiologies of severe hypoxic hepatitis were acute myocardial infarction and sepsis. Fifty-three patients (71%) died during the hospitalization. The sole independent predictive factor for mortality was serum albumin measured at the onset of severe hypoxic hepatitis. Patients with low serum albumin of less than 28 g/L have more than five-fold increase risk of death (OR = 5.39, 95%CI: 1.85-15.71).

Severe hypoxic hepatitis is uncommon but has a high mortality rate. Patients with low serum albumin are at highest risk of death.

• Severe
• Mortality
• Albumin
• Incidence
• Hypoxic hepatitis
• Predictors
• Etiology
• Prognosis