Оbjective Our aim was to describe the difference in epicardial coronary flow at baseline on background anti-ischaemic
therapy and following intracoronary
glyceryl trinitrate in patients with
acute coronary syndrome and non-obstructive
coronary disease with and without myocardial bridges and coronary artery fistulae. Materials and methods Coronary flow was characterized in a group of 88 patients with
coronary stenoses <50% diagnosed with
acute coronary syndrome using the corrected Thrombolysis in
Myocardial Infarction frame count (
cTFC) method at coronary angiography at baseline and after the application of 200 µg
glyceryl trinitrate. Results Тhe patients with myocardial bridges and coronary artery fistulae accounted for 4.4% (n=4) and 2.2% (n=2), respectively, of the patients with
acute coronary syndrome. Sixty-two (70%) of all patients demonstrated slow progression of the
contrast media (
cTFC>25 frames) in at least one coronary artery. Coronary flow was similarly impaired in the patients with myocardial bridges, coronary artery fistulae, and those without coronary anomalies and variants. After the intracoronary infusion of
glyceryl trinitrate, the epicardial flow improved in the patients with myocardial bridges and to a lesser degree in the cases with coronary fistulae. Most of the patients who responded to
glyceryl trinitrate were on background
therapy with
calcium channel blockers. Conclusion The epicardial coronary flow of patients with non-obstructive coronary disease with myocardial bridges and
acute coronary syndrome showed less impairment compared to baseline in response to intracoronary
glyceryl trinitrate applied at background anti-ischaemic
therapy that included
calcium channel blockers.