Definitions and incidence of cardiac syndrome X: review and analysis of clinical data

I. A. C. Vermeltfoort*, P. G. H. M. Raijmakers, I. I. Riphagen, D. A. M. Odekerken, A. F. M. Kuijper, A. Zwijnenburg, G. J. J. Teule

*Corresponding author for this work

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There is no consensus regarding the definition of cardiac syndrome X (CSX). We systematically reviewed recent literature using a standardized search strategy. We included 57 articles. A total of 47 studies mentioned a male/female distribution. A meta-analysis yielded a pooled proportion of females of 0.56 (n = 1,934 patients, with 95% confidence interval: 0.54-0.59). As much as 9 inclusion criteria and 43 exclusion criteria were found in the 57 articles. Applying these criteria to a population with normal coronary angiograms and treated in 1 year at a general hospital, the attributable CSX incidence varied between 3 and 11%. The many inclusion and exclusion criteria result in a wide range of definitions of CSX and these have large effects on the incidence. This shows the need for a generally accepted definition of CSX.
Original languageEnglish
Pages (from-to)475-481
JournalClinical research in cardiology
Issue number8
Publication statusPublished - Aug 2010


  • Cardiac syndrome X
  • Microvascular angina
  • Angina pectoris and normal coronary arteries

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