title: Assessment of the relationship between red cell distribution width and cardiac syndrome X.
abstract: BACKGROUND
  Cardiac syndrome X (CSX) is characterised by angina-like chest pain, a positive stress test, and normal coronary arteries. Increased red cell distribution width (RDW) level may be indicative of an underlying inflammatory state.
  
  
  OBJECTIVE
  To investigate RDW level in patients with CSX and compare patients having coronary artery disease (CAD) and normal subjects.
  
  
  METHODS
  245 subjects (79 patients with CSX, 81 patients with CAD, and 85 controls) were enrolled in the study. The CSX group consisted of patients with anginal chest pain, ischaemia on noninvasive stress test and a normal coronary angiogram.CAD was defined as ≥ 50% stenosis in at least one coronary artery. The control group was selected from the patients with anginal symptoms but a normal stress test and a normal coronary angiogram. RDW measurements among the three groups were compared.
  
  
  RESULTS
  Baseline clinical and biochemical characteristics were not different among the three groups. There were no statistically significant differences in RDW levels between the CSX and CAD groups (p = 0.17). RDW measurements in both the CSX and CAD groups were found to be significantly higher than the control group (p < 0.01).
  
  
  CONCLUSIONS
  We discovered that patients with CSX and CAD have significantly higher RDW measurements compared to controls. The relationship between CSX and higher RDW level suggests that endothelial dysfunction may also contribute to the etiopathogenesis of the CSX phenomenon as it does with CAD.
authors.affiliation: Department of Cardiology, School of Medicine, Gulhane Medical Academy, Etlik-Ankara, Turkey. saitdemirkol@yahoo.com
authors.forename: Sait
authors.initials: S
authors.lastname: Demirkol
authors.forename: Sevket
authors.initials: S
authors.lastname: Balta
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Arslan
authors.forename: Murat
authors.initials: M
authors.lastname: Unlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cakar
authors.forename: Ugur
authors.initials: U
authors.lastname: Kucuk
authors.forename: Seref
authors.initials: S
authors.lastname: Demirbas
authors.forename: Atila
authors.initials: A
authors.lastname: Iyisoy
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yokusoglu
mesh_terms: D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis; D003937:Diagnosis, Differential; D004909:Erythrocyte Indices; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000097:blood* / Q000175:diagnosis*; D008875:Middle Aged; D012016:Reference Values; D012189:Retrospective Studies