Key result
Elevated CRP is linked to small-vessel inflammation in ~76% of women with cardiac syndrome X.
Why the study?
The pathogenesis and pathohistological changes of Cardiac Syndrome X in patients with increased CRP levels are poorly understood.
Cross-Sectional (n=31)
No
Female patients with Cardiac Syndrome X and elevated CRP exhibit signs of inflammation and endothelial apoptosis in small endomyocardial blood vessels, suggesting an inflammatory component to the pathogenesis.
May support inflammation in female CSX; hypothesis-generating and should not yet change practice.
The pathogenesis and pathohistological changes of CSX, a syndrome characterized by anginal chest pain and normal coronary arteries on coronary angiography, is poorly understood. The purpose of this study was to analyse morphological changes in small blood vessels of the CSX patients with increased CRP levels (above 5 mg/l). EMB was performed for diagnostic purposes in 31 female patients with CSX, and EMB specimens were histologically and immunohistochemically analysed. Increased CRP was found in 18 (58.1%) female patients with CSX. Signs of inflammation in the walls of small blood vessels were demonstrated in 13 (76%) and TUNEL-positive endothelial cells in 3 (17%) women with increased CRP. Morphological analysis of small blood vessels in EMB in CSX female patients with increased CRP levels revealed signs of inflammation and apoptosis of endothelial cells, indicating the role of inflammation in the pathogenesis of CSX.
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Zorc‐Pleskovič et al. (2008) conducted a cross-sectional in Cardiac Syndrome X (n=31). Increased C-reactive protein (> 5 mg/l) vs. Normal C-reactive protein (≤ 5 mg/l) was evaluated on Signs of inflammation in small blood vessels (endothelial edema, mononuclear and polymorphonuclear infiltration). In female patients with cardiac syndrome X, elevated C-reactive protein (>5 mg/L) was associated with signs of inflammation in small blood vessels in 76% of cases, compared to 0% in those with normal CRP.
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