Definitions and incidence of cardiac syndrome X: review and analysis of clinical data

Vermeltfoort, Ilse A C; Raijmakers, Pieter; Riphagen, Ingrid I.; Odekerken, D. A. M.; Kuijper, Aaf F.M.; Zwijnenburg, A.; Teule, G. J. J.

doi:10.1007/s00392-010-0159-1

Cited by 79 publications

(73 citation statements)

References 54 publications

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“…In contrary to our study it is generally accepted that, CSX affects women (25). But in a recent large scale analysis, Vermeltfoort et al (26) reported that CSX was also common among men as 44% of the CSX population was men. This finding may be incidental or associated with our strict exercise test criteria as we excluded patients with only angina and/or upsloping ECG depression in our study.…”

Section: Discussioncontrasting

confidence: 99%

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Aykan¹,

Gökdeniz²,

Gül³

et al. 2013

Anadolu Kardiyol Derg

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Objective: Arterial stiffness is associated with major adverse cardiovascular events. Cardio-ankle vascular index (CAVI), a novel marker of arterial stiffness, which is weakly influenced by systolic blood pressure, is a sensitive marker the atherosclerosis and arteriolosclerosis. The aim of this study is to investigate arterial stiffness by CAVI in patients with cardiac syndrome X (CSX). Methods: The present study was observational and cross sectional, and involved 49 patients (26 male) with CSX (angina-like chest pain, positive electrocardiographic ischemic changes at treadmill exercise test, angiographically normal coronary arteries) and 54 healthy subjects (21 male). CAVI was measured by VaSera-1000 CAVI instrument. Statistical analysis was performed using the Chi-square, Student t-test, correlation analysis and logistic regression analysis. Results: The CAVI and pulse pressure were significantly increased in patients with CSX compared to control group (7.50±1.50, 6.49±0.77, p<0.001; 53.00±10.06, 47.39±8.17, p=0.002, consecutively). In contrast, there were no significant differences in the age, weight, height, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, mean blood pressure, glucose, low density lipoprotein level, high density lipoprotein level (HDL), triglyceride, estimated creatinine clearance, hemoglobin, left atrium diameter, left ventricular mass (LVM), LVM index and ejection fraction. CAVI was the only independent predictor of CSX in logistic regression analysis (OR=1.780, 95% CI: 1.157-2.737, p=0.009). Conclusion: CAVI is increased in syndrome X patients and is an independent predictor of this syndrome. (Anadolu Kardiyol Derg 2013; 13: 766-71) Key words: CAVI, arterial stiffness, cardiac syndrome X, coronary, angiography, regression analysis Original Investigation Özgün Araşt›rma 766ÖZET Amaç: Damar sertliği önemli kardiyovasküler kötü hadiselerle ilişkilidir. Kalp-ayak bileği vasküler indeks ölçümü (KAVI), sistolik kan basıncından çok az etkilenir ve damar sertliği değerlendirilmesinde yeni ve hassas bir yöntem olup ateroskleroz ve arteriolosklerozun hassas bir gösterge-sidir. Bu çalışmanın amacı kardiyak sendrom-X'li hastalarda (KSX) KAVI yöntemi ile damar sertliğinin değerlendirilmesidir. Yöntemler: Çalışmamız gözlemsel ve kesitsel nitelikte olup, bu çalışmada 49 KSX (tipik göğüs ağrısı olan, egzersiz elektrokardiyografi testinde pozitif iskemik değişiklikleri bulunan ve yapılan koroner anjiyografide normal koroner arterler tespit edilen hastalar) (29 erkek) ve 54 sağlıklı hasta (21 erkek) değerlendirildi. KAVI VaSera-1000 KAVI aletiyle ölçüldü. İstatistiksel analizde Ki-kare, t-testi, korelasyon analizi ve mantıksal regresyon analizi kullanıldı. Bulgular: KSX hastalarında KAVI ve nabız basıncı kontrol grubuna göre anlamlı olarak daha yüksekti

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Section: Discussioncontrasting

confidence: 99%

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Aykan¹,

Gökdeniz²,

Gül³

et al. 2013

Anadolu Kardiyol Derg

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“…In the majority of these cases, chronic stable angina is caused by coronary microvascular dysfunction. This condition, previously known as cardiac syndrome X, is named microvascular angina, which often pertains to women with symptoms of chronic stable angina, normal or near-normal coronary arteries, and evidence of ischaemia during stress testing or during acetylcholine testing 13,14 . Increasing attention has been focused on the recognition of this condition, and microvascular angina might occur in up to 40% of patients with angina, depending on the studies [15][16][17] .…”

Section: Pathophysiologymentioning

confidence: 99%

A 'diamond' approach to personalized treatment of angina

et al. 2017

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Chronic stable angina pectoris is the most prevalent symptomatic manifestation of ischaemic heart disease, and its management is a priority (BOX 1). Current clinical guidelines recommend antianginal therapy to control symptoms, before considering coronary artery revasculariza tion [1][2][3][4] . However, revascularization by either percutaneous coronary angioplasty or CABG surgery is indicated in patients who have significant artery steno sis (50% left main narrowing or proximal three-vessel disease) to reduce myocardial ischaemia and its adverse clinical manifestation. Antianginal agents are approved by documenting that they improve total exercise duration, together with a reduction in daily frequency of chronic stable angina compared with placebo and/or equivalence to an active comparator. Cardiovascular outcomes, although highly advocated, are not a pre requisite for regulatory approval. None of the antianginal drugs has been proved to reduce cardiovascular mortality or the rate of myocardial infarction. When patients are optimally treated, mortality for chronic stable angina is low, which might explain why all trials designed to improve prognosis have been negative. Guidelines recom mend a first-choice and a second-choice approach, based more on tradition and expert opinion, rather than evidence. This categorical approach has been questioned in the past couple of years 5-8 . Newer antianginal drugs, which are classified as second choice, have more evidence-based clinical data that are more contemporary to support their use than is available for the traditional first-choice drugs. Equally, the often-needed combin ation of double or triple therapy is based on expert opinion and not related to the underlying pathophysio logy. What constitutes optimal antianginal treatment, therefore, varies considerably between countries, and the majority of doctors treat their patients according to their own preconceptions.A group of experts with experience and interest in chronic stable angina met at the University of Ferrara, Italy, to discuss an individualized approach to medical treatment of chronic stable angina, on the basis E X P E RT C O N S E N S U S D O C U M E N TA 'diamond' approach to personalized treatment of angina Abstract | In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for tr...

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“…В настоящее время остается открытым вопрос о допустимых изменениях коронарных артерий при МСС. Некоторые исследователи считают, что изменений КА не должно быть совсем, другие -допускают стенозирование до 20-50 % с подтверждением отсутствия гемодинамически значимых изменений методом оценки фракционного резерва кровотока [7,33,34]. Нельзя относить пациентов с мышечными мостиками и аномалиями отхождения КА к группе больных с МСС.…”

Section: рисунок 1 патогенез микрососудистой стенокардии [22]unclassified

“…Как правило, больные с первичной МСС моложе, чем паци-енты с классической стенокардией, вследствие атеросклероза коронарных артерий, и их средний возраст составляет 49 ± 9 лет [2,6,7].…”

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