Long-term prognosis of patients with cardiac syndrome X.
BACKGROUND
Previous follow-up studies of patients with cardiac syndrome X (CSX) reported good prognosis. However, some recent reports challenged this finding by showing appreciable mortality rates in patients with angina and normal coronary arteries admitted for acute coronary syndromes.


METHODS
We performed clinical follow-up of 155 patients (mean age 58.9+/-10 years, 40 men) with typical CSX. The occurrence of major cardiac events (cardiac death, acute myocardial infarction), readmission for chest pain, revascularization procedures, angina status, and non cardiac events during follow-up were collected for each patient.


RESULTS
At a mean follow-up time of 137+/-78 months (range 24-372) from the onset of symptoms, 4 patients died, 3 for cancers and 1 for acute pancreatitis. No patient died from cardiovascular causes or had any major cardiovascular event. Hospital readmission for recurrent chest pain was reported by 89 patients (58%), and 33 (22%) underwent at least one more coronary angiography. During follow-up, chest pain had remained unchanged in 33% of patients and had worsened in 14% of patients.


CONCLUSIONS
Our data show that patients with CSX have excellent long-term clinical prognosis. A significant number of patients, however, shows persistence or worsening of symptoms, as well as further recurrence to medical evaluation.
Lamendola
Priscilla
P
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
Lanza
Gaetano A
GA
Spinelli
Antonella
A
Sgueglia
Gregory A
GA
Di Monaco
Antonio
A
Barone
Lucy
L
Sestito
Alfonso
A
Crea
Filippo
F
D054058:Acute Coronary Syndrome / Q000401:mortality*; D000368:Aged; D000787:Angina Pectoris / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000401:mortality*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D009369:Neoplasms / Q000401:mortality; D010195:Pancreatitis / Q000401:mortality; D011379:Prognosis; D013997:Time Factors