Abstract
AimsFollow-up studies of patients with cardiac syndrome X (CSX) generally report good prognosis. However, some recent studies report an adverse outcome for women.Methods and resultsStructured literature search and meta-analysis for studies regarding prognosis of cardiac syndrome X patients. We identified 85 studies, ultimately selecting 16 for inclusion. Meta-analysis yielded a pooled major cardiac event percentage of 1.5% per 5 years and a pooled vascular event percentage of 4.8% per 5 years (n = 16 studies, n = 1694 patients). Fourteen studies reported upon the recurrence rate of angina pectoris: the pooled percentage of angina recurrence was 55% (n = 1336 patients).ConclusionThe present review of recent archival literature demonstrates an overall major cardiac event rate of 1.5% per 5 years. Although this is an excellent prognosis for CSX patients, the quality of life is impaired because of the high recurrence rate of angina pectoris (55%).
Highlights
Cardiac syndrome X (CSX) is the syndrome of angina pectoris during a positive stress test despite a normal coronary arteriogram
The three most important results relating to prognosis are: (1) The major cardiac event rate varied from 0% to 3.8% per 5 years, with a pooled value of 1.5% per 5 years (Fig. 1)
The Women’s Ischaemia Syndrome Evaluation (WISE) study CSX event rate lies outside the 95% confidence interval of 3.8%–5.9% per 5 years that we found from our reviewed studies
Summary
Cardiac syndrome X (CSX) is the syndrome of angina pectoris during a positive stress test despite a normal coronary arteriogram. About 3–11% of patients undergoing coronary angiography because of typical chest pain have normal coronary arteries and qualify for the definition of CSX [19]. Follow-up studies of patients with CSX generally report good prognosis [7, 9]. A recent study reported an adverse cardiovascular outcome for women with chest pain and normal coronary arteries [6]. The present paper reviews the recent literature on CSX to discuss in detail the long-term prognosis
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