title: Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon.
abstract: OBJECTIVE
  Endothelial dysfunction may play a role in the pathogenesis of the slow coronary flow (SCF) phenomenon. A detailed examination of blood cellular components has not been performed for this condition. We investigated the relationship between SCF and whole blood cell counts.
  
  
  METHODS
  Records of 17,315 patients who underwent coronary angiography between January 2006 and December 2012 were evaluated retrospectively. A total of 146 patients with SCF were compared with 148 patients with normal coronary arteries according to demographic data, complete blood count, and biochemical parameters.
  
  
  RESULTS
  The following parameters were significantly higher in SCF patients than in patients with normal coronary arteries: percentage of smokers (36.3% vs. 25%, p=0.036), body mass index (26.69 ± 2.84 vs. 26.07 ± 3.15, p=0.049), white blood cells (WBCs) (7.52 ± 1.43 × 10(3)mm(-3) vs. 7.01 ± 1.42 × 10(3)mm(-3), p=0.002), red cell distribution width (RDW) (13.68 ± 1.42% vs. 13.15 ± 1.13%, p<0.001), platelets (250.29 ± 50.96 × 10(3)mm(-3) vs. 226.10 ± 38.02 × 10(3)mm(-3), p<0.001), plateletcrit (PCT) (0.214 ± 0.40% vs. 0.184 ±0.29%, p<0.001), mean platelet volume (8.63 ± 1.10fL vs. 8.22 ± 0.83 fL, p<0.001), platelet distribution width (PDW) (16.58 ± 0.76% vs. 16.45 ± 0.57%, p=0.028), and neutrophils (4.44 ± 1.25 × 10(3)mm(-3) vs. 4.12 ± 1.24 × 10(3)mm(-3), p=0.029). Positive PCT values [odds ratio (OR), 4.165; 95% confidence interval (CI), 2.493-6.959; p<0.001) and RDW (OR, 1.304; 95% CI, 1.034-1.645; p=0.025) were independent predictors of SCF.
  
  
  CONCLUSIONS
  Although within the normal range, the increased numbers of WBCs and neutrophils in patients with SCF suggest that SCF may be a subclinical inflammatory condition. Furthermore, increased RDW and PDW in SCF patients may cause microvascular blood flow resistance due to impaired cell deformability. The PCT provides reliable data regarding total platelet mass and may be a useful predictor of SCF.
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey. Electronic address: dr.ibrahimakpinar@gmail.com.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akpinar
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Muhammet Rasit
authors.initials: MR
authors.lastname: Sayin
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Yusuf Cemil
authors.initials: YC
authors.lastname: Gursoy
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Ziyaeddin
authors.initials: Z
authors.lastname: Aktop
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Karabag
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Kucuk
authors.affiliation: Mustafa Kemal University, Faculty of Medicine, Department of Cardiology, Hatay, 31000, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
authors.affiliation: Bulent Ecevit University, Faculty of Medicine, Department of Public Health, Zonguldak, 67600, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Kiran
authors.affiliation: Bulent Ecevit University School of Medicine, Department of Biostatistics, Zonguldak, 67600, Turkey.
authors.forename: Mustafa Cagatay
authors.initials: MC
authors.lastname: Buyukuysal
authors.affiliation: Hacettepe University School of Medicine, Department of Hematology, Ankara, 06100, Turkey.
authors.forename: Ibrahim Celal
authors.initials: IC
authors.lastname: Haznedaroglu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003326:Coronary Circulation; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010976:Platelet Count; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors
keywords: Plateletcrit; Red cell distribution; Slow coronary flow