Ramazan Astan
Intercontinental Journal of Internal Medicine - 2025;3(4):73-76
Aims: Coronary slow flow (CSF) is an angiographic phenomenon characterized by delayed distal opacification of coronary arteries despite the absence of obstructive lesions. Although thyroid hormones are known to modulate cardiovascular hemodynamics, their potential association with CSF remains uncertain. Methods: This retrospective, single-center, observational study included 170 patients (85 with angiographically confirmed CSF and 85 with normal coronary flow). Patients with overt thyroid dysfunction were excluded. Demographic, clinical, and biochemical characteristics were compared between the groups. Thyroid-related parameters (TSH, FT3, FT4, and FT4/FT3 ratio) were analyzed using receiver operating characteristic (ROC) curves and logistic regression to determine their discriminative and independent predictive value for CSF. Results: Patients with CSF were significantly younger (49.3+/-10.0 vs. 54.8+/-11.1 years, p<0.001), predominantly male (72.9% vs. 47.1%, p=0.001), and more frequently smokers (59.0% vs. 36.9%, p=0.021) compared with controls. In multivariable logistic regression analysis, only age remained an independent predictor of CSF (OR 0.95, 95% CI 0.92-0.98, p=0.002). None of the thyroid parameters, including the FT4/FT3 ratio, demonstrated significant discriminative ability for CSF in ROC curve analysis (all AUC <0.60, p>0.05). Conclusion: In euthyroid individuals, thyroid hormone levels and their ratios were not independently associated with coronary slow flow, whereas younger age and smoking emerged as stronger correlates. These findings suggest that routine thyroid hormone evaluation may not offer additional diagnostic or prognostic value in CSF.
