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This study aimed to evaluate the association between inflammatory indices and the presence of CSF in patients undergoing coronary angiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An analytical cross-sectional study with an exploratory design was conducted in 77 patients undergoing coronary angiography, including those with CSF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943) and controls with angiographically normal coronary arteries (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934). Clinical, biochemical, and hematological variables, TNF-\u03b1 levels, and inflammatory indices (TyG, NLR, LMR, NPR, PIV, and SIRI) were assessed. Appropriate statistical tests and an exploratory multivariate logistic regression model were performed to evaluate associations with CSF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of CSF was 2.6%, with hypertension and dyslipidemia being the most frequent comorbidities. Patients with CSF exhibited significantly higher levels of total cholesterol (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), LDL cholesterol (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), monocytes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), and neutrophils (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Inflammatory indices TyG, NLR, NPR, PIV, and SIRI were significantly elevated in the CSF group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), whereas LMR was lower. No significant differences were found in TNF-\u03b1 levels, although elevated values were observed in both groups. Multivariate logistic regression analysis did not identify statistically significant independent predictors of coronary slow flow.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSF appears to represent a systemic inflammatory and microvascular phenotype rather than an isolated angiographic finding. Patients with CSF exhibited higher values of integrated inflammatory indices, suggesting a coordinated cardiometabolic inflammatory profile. These indices may serve as practical and accessible complementary markers associated with CSF; however, they should be considered hypothesis-generating rather than validated diagnostic tools. Larger prospective multicenter studies are required to confirm these associations and their clinical implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05861-2","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:26:44Z","timestamp":1776756404000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Coronary slow flow: role of systemic inflammation and biomarkers in its pathophysiology"],"prefix":"10.1186","volume":"26","author":[{"given":"Myrna Vianney Mu\u00f1oz","family":"Flores","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argui\u00f1e Ivonne Urraza","family":"Robledo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faviel Francisco Gonz\u00e1lez","family":"Galarza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fany Karina Segura","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor Alberto Delgado","family":"Aguirre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Esteban Bazzoni","family":"Ruiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Navarro P\u00e9rez","family":"Macedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arist\u00f3teles Ram\u00edrez","family":"Salazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Carlos L\u00f3pez","family":"M\u00e1rquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"5861_CR1","unstructured":"World Health Organization. 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All participants received detailed information about the study, and written informed consent was obtained. The research was conducted in accordance with the principles of the Declaration of Helsinki and the Belmont Report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"\u201cNot applicable\u201d.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"472"}}