Relationship between Diabetes and Syndrome X in women with stable angina

摘要

Background: Cardiac Syndrome X describes patients with angina,compatible findings with myocardial ischemia and normal coronaryangiograms. It is an important clinical entity that should bedistinguished from ischemic heart disease caused by obstructivecoronary artery disease.Aims: Several studies have already established the predominanceof Syndrome X in female population. In our study, we analyse theprevalence of Syndrome X in female population and the significanceof age, menopausal status, diabetes and hypertension withsyndrome X.Methods: This is a observational study conducted in the Departmentof Cardiology in a tertiary care centre in Chennai during theperiod of May to July 2014. A total of 50 female patients withanginal symptoms and evidence of myocardial ischemia in theform of positive treadmill test by Bruce protocol were included.They underwent diagnostic coronary angiogram. The pattern ofcoronary artery involvement was analysed.Results: Out of the 50 female patients who underwent coronaryangiograms, 20 (40%) patients had normal coronary arteries. Ofthese 20 patients, 16 (80%) were post-menopausal and 4 (20%)were pre-menopausal. Diabetic population among the patientswith normal coronaries were 12 (60%), hypertensive non-diabeticpopulation were 5 (25%) patients, non-diabetic non-hypertensivepopulation were 3 (15%) patients. Average age among patientswith normal coronary angiogram was 54 years, with average agebeing lower in diabetics (52 years) compared to non diabetics (58years).Conclusion: Cardiac syndrome X has a higher prevalence in femalepopulation in the post menopausal age group. Diabeticpopulation was associated with greater incidence of syndrome Xwith a lower average age compared to non diabetic women. Theanalysis of diabetic and non-diabetic patients with cardiac syndromeX in this study has shown that diabetic population has agreater involvement of coronary microcirculation at an earlierage.