Therapeutic development in cardiac syndrome X: a need to target the underlying pathophysiology

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    Abstract

    Morbidity of patients with cardiac syndrome X (typical anginal-like chest pain and normal coronary arteriogram) is high with continuing episodes of chest pain and frequent hospital readmissions. Management of this syndrome represents a major challenge for the treating physician. Conventional therapies with antianginal agents such as nitrates, calcium channel antagonists, classic beta-adrenoceptor blockers and nicorandil have been tried, with variable success. However, this might be related to a failure to target the underlying pathophysiology and, clearly, more effective therapies are needed. Supporting evidence for the important role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X has come from the recent observation that basal superoxide production predicts future cardiovascular events in this patient group. This review will discuss the pathophysiology, current medical management and potential new pharmacological treatment for patients with cardiac syndrome X which target endothelial dysfunction and oxidative stress.

    What's already known about this topic ?

    center dot Morbidity of patients with cardiac syndrome X is high.

    center dot The important role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X.

    What does this article add ?

    center dot This review will discuss the pathophysiology, current medical management and potential new pharmacological treatment for patients with cardiac syndrome X which target endothelial dysfunction and oxidative stress.

    Original languageEnglish
    Pages (from-to)49-58
    Number of pages10
    JournalCardiovascular Therapeutics
    Volume27
    Issue number1
    DOIs
    Publication statusPublished - 2009

    Keywords

    • Cardiac syndrome X
    • Chest pain
    • Endothelial dysfunction
    • Microvascular dysfunction
    • Normal coronary angiogram
    • NORMAL CORONARY ANGIOGRAMS
    • CARDIOVASCULAR MAGNETIC-RESONANCE
    • IMPROVES ENDOTHELIAL FUNCTION
    • CONVERTING ENZYME-INHIBITION
    • XANTHINE-OXIDASE INHIBITORS
    • EXERCISE-INDUCED ANGINA
    • ST SEGMENT DEPRESSION
    • LONG-TERM PROGNOSIS
    • C-REACTIVE PROTEIN
    • CHEST-PAIN

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