Coronary artery calcification in women with syndrome X: Usefulness of double-helical CT for detection

PURPOSE: To determine the usefulness of double-helical computed tomography (CT) for detection of diseased coronary arteries in women with anginal pain, positive exercise stress test results, and angiographically normal coronary arteries (syndrome X). MATERIALS AND METHODS: Double-helical CT of the coronary arteries was performed in 81 consecutive women who were referred for coronary angiography for evaluation of chest pain. Patients were classified into three groups according to stress test and angiographic results: normal (normal exercise test results and angiographically normal coronary arteries), syndrome X (abnormal exercise test results and angiographically normal coronary arteries), and coronary artery disease (at least one diseased vessel seen at angiography). RESULTS: The prevalence of coronary calcification in the syndrome X group was 63% (10 of 16 patients) compared with 96% (45 of 47 patients) in the coronary artery disease group (P = .002) and 22% (four of 18 patients) in the normal group (P = .02). The lowest total coronary calcification score and logarithmic trans- formed data were found in the normal group (2.9 ± 0.7), statistically significantly higher values were found in the syndrome X group (4.3 ± 1.5), and the highest values were found in the coronary artery disease group (5.1 ± 2.0; for trend, P = .03). CONCLUSION: Double-helical CT may be useful in detection of atherosclerosis in women with syndrome X who demonstrate normal coronary arteries at angiography.