Trial reportJournal of the American College of Cardiology2014
Sex differences in platelet reactivity and cardiovascular and psychological response to mental stress in patients with stable ischemic heart disease: insights from the REMIT study.
Trial report in Journal of the American College of Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00574847 (Responses of Myocardial Ischemia to Escitalopram Treatment), which is not on this map. Cited by 42 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT Trial)
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.
- A meta-analysis on the prevalence, associated factors and diagnostic methods of mental stress induced myocardial ischemia.Journal of translational medicine · 2020Pooled it
- Mental Stress-Induced-Myocardial Ischemia in Young Patients With Recent Myocardial Infarction: Sex Differences and Mechanisms.Circulation · 2018Trial
- Increased Cardiac Workload in the Upright Posture in Men: Noninvasive Hemodynamics in Men Versus Women.Journal of the American Heart Association · 2016Trial
- Dose-dependent association between elevated resting IL-6 levels and severity of mental stress-induced myocardial perfusion defects.Psychological medicine · 2026Article
- Heightened Risk of Myocardial Ischemia With Mental Stress Among Black Women Survivors of a Myocardial Infarction in Midlife.Journal of the American Heart Association · 2026Article
- Cardiovascular imaging in women: from diagnostic bias to inclusive cardiovascular science.European heart journal. Imaging methods and practice · 2026Article
- Sex differences in mortality after percutaneous coronary intervention: a contemporary nationwide registry and prospective cohort analysis.Annals of translational medicine · 2025Article
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 2024Review
- Recommendations for the Application of Sex and Gender Medicine in Preclinical, Epidemiological and Clinical Research.Journal of personalized medicine · 2024Review
- The Role of Psychosocial Stress on Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- Differences in Risk Factors for Coronary Atherosclerosis According to Sex.Journal of lipid and atherosclerosis · 2024Review
- Central stress pathways in the development of cardiovascular disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Review
- Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis.American heart journal plus : cardiology research and practice · 2023Article
- Sex Differences in Coronary Artery Disease: Insights From the KoRean wOmen'S chest pain rEgistry (KoROSE).Korean circulation journal · 2023Review
- Life's simple 7 and its association with trajectories in depressive symptoms among urban middle-aged adults.Journal of affective disorders · 2023Article
- The sex-dependent response to psychosocial stress and ischaemic heart disease.Frontiers in cardiovascular medicine · 2023Review
- Gender Disparities Between Neighborhood Social Vulnerability and Psychological Distress Among Patients with Heart Disease.Journal of women's health (2002) · 2022Article
- The Impact of Mental Stress on Cardiovascular Health-Part II.Journal of clinical medicine · 2022Review
- Sex-Specific Differences in Cardiovascular Risk, Risk Factors and Risk Management in the Peripheral Arterial Disease Population.Diagnostics (Basel, Switzerland) · 2022Review
- Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology.Biomolecules · 2021Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundAlthough emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified.
objectivesWe aimed to study the differential psychological and cardiovascular responses to mental stress between male and female patients with stable IHD.
methodsPatients with stable IHD enrolled in the REMIT (Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram) study underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after 3 mental stress tasks. Mental stress-induced myocardial ischemia (MSIMI) was defined as the development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8% by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during 1 or more of the 3 mental stress tasks.
resultsIn the 310 participants with known IHD (18% women, 82% men), most baseline characteristics were similar between women and men (including heart rate, blood pressure, and LVEF), although women were more likely to be nonwhite, living alone (p < 0.001), and unmarried (p < 0.001); they also had higher baseline depression and anxiety (p < 0.05). At rest, women had heightened platelet aggregation responses to serotonin (p = 0.007) and epinephrine (p = 0.004) compared with men. Following mental stress, women had more MSIMI (57% vs. 41%; p < 0.04), expressed more negative (p = 0.02) and less positive emotion (p < 0.001), and demonstrated higher collagen-stimulated platelet aggregation responses (p = 0.04) than men. Men were more likely than women to show changes in traditional physiological measures, such as blood pressure (p < 0.05) and double product.
conclusionsIn this exploratory analysis, we identified clear, measurable, and differential responses to mental stress in women and men. Further studies should test the association of sex differences in cardiovascular and platelet reactivity in response to mental stress and long-term outcomes. (Responses of Myocardial Ischemia to Escitalopram Treatment [REMIT]; NCT00574847).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.