Key result
Cardiac syndrome X is linked to ~2.7-second longer microcirculatory transit time versus controls.
Why the study?
Cardiac syndrome X is not benign and requires long-term follow-up and risk factor modification; microcirculatory transit time may serve as a risk stratification method but needs evaluation.
Cross-Sectional (n=52)
No
Absolute Event Rate: 6.5% vs 3.8%
p-value: p=<0.001
Microcirculatory transit time should not yet guide CSX risk stratification; leaves open its value pending prospective validation.
BACKGROUND Cardiac syndrome X (CSX) is not benign, and it needs long-term follow up and risk factor modification. In this study, we wanted to calculate microcirculatory transit time on coronary angiography in patients with cardiac syndrome X (CSX), compare microcirculatory transit time in patients with and without CSX and to see whether microcirculatory transit time can be proposed as a risk stratification method in CSX. METHODS Cross sectional study of 52 patients. The angiogram was taken at 15 frames per second. The left coronary artery was injected with 7 ml of contrast approximately. Microcirculatory transit time (MCTT) was obtained offline. The microcirculatory transit time in seconds is calculated as last frame count minus first frame count/15. Microcirculatory transit time was compared and analysed in both groups. RESULTS A total of 52 subjects were analysed. There were 26 cases in the angina group with a mean age of 49.96 years and 26 cases in the control group with a mean age of 50.32 years. Dyslipidemia, smoking and statin use were more common in the angina group, which was statistically significant (P < 0.05). The mean MCTT of the group with angina and positive treadmill test (TMT) was 6.76 seconds, whereas the negative TMT group was 6.39 seconds. The mean frame count was 58.1, and the mean MCTT was 3.8 seconds in the control group, whereas the mean frame count and mean MCTT were 98.1 and 6.5 seconds in the angina group, which was statistically significant (P < 0.001). CONCLUSIONS CSX patients had longer MCTT than patients without chest pain and normal coronary arteries. MCTT can be used to assess the risks of CSX. Long-term followup studies with a large sample size should be conducted.
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Reddy et al. (2021) conducted a cross-sectional in Cardiac Syndrome X (n=52). Cardiac Syndrome X vs. Control group without chest pain and normal coronary arteries was evaluated on Mean microcirculatory transit time (MCTT) in seconds (p=<0.001). Patients with cardiac syndrome X had a significantly longer mean microcirculatory transit time compared to controls without chest pain and normal coronary arteries (6.5 vs 3.8 seconds, P<0.001).
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