Study of Clinical Profile of Coronary Artery Disease in Tertiary Care Hospital with Special Reference to Syndrome X

Abstract

 Introduction: Coronary artery disease (CAD) remains a major contributor to global morbidity and mortality, particularly in low- and middle-income countries such as India. While CAD is typically attributed to atherosclerotic obstruction of epicardial vessels, a subset of patients present with anginal symptoms and ischemia despite near-normal coronary angiography, termed Syndrome X (microvascular angina). This study was undertaken to evaluate the clinical profile of CAD patients with special reference to Syndrome X in a tertiary care setting.

Material and Methods: This was a prospective observational study conducted from July 2023 to June 2025 in a tertiary care hospital. A total of 200 patients presenting with acute coronary syndrome-like symptoms (chest pain, palpitations, syncope) and relevant electrocardiographic or biochemical changes were included. Patients were assessed through demographic parameters, risk factors (hypertension, diabetes, hyperlipidemia, obesity, addictions, diet), clinical signs, biochemical markers, and outcomes. Syndrome X was defined using NCEP ATP III criteria for metabolic syndrome. Statistical analysis was performed to identify associations between risk factors, Syndrome X, and clinical outcomes.

Results: The mean age group affected was 61–75 years (45.5%), with male predominance (65.5%). Chest pain was the most common presenting symptom (99%). Major comorbidities included hypertension (54.5%), hyperlipidemia (57%), and obesity (overweight/obese 70.5%). Syndrome X was identified in a significant subset, more common among females. Outcomes showed that 30.5% were referred for coronary angiography after thrombolysis, 24.5% were discharged after thrombolysis and anticoagulation, while 17.5% succumbed during hospitalization.

Conclusion: CAD predominantly affects older males, with hypertension, hyperlipidemia, and obesity being major contributors. Syndrome X, though under-recognized, was prevalent, particularly in women, carried important prognostic implications. Early identification of metabolic syndrome in CAD patients is crucial for timely interventions to improve outcomes.