Evidence map›Paper›PMID 25918056›Full record

Observational studyInternational journal of cardiology2015

Utility of both carotid intima-media thickness and endothelial function for cardiovascular risk stratification in patients with angina-like symptoms.

Yasushi Matsuzawa, Sara Svedlund, Tatsuo Aoki, Raviteja R Guddeti, Taek-Geun Kwon, Rebecca Cilluffo, R Jay Widmer, Rebecca E Nelson, Ryan J Lennon, Lilach O Lerman and 4 more

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 2 countries.

Yasushi MatsuzawaDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Sara SvedlundDepartment of Clinical Physiology, Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
Tatsuo AokiDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Raviteja R GuddetiDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Taek-Geun KwonDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Rebecca CilluffoDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
R Jay WidmerDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Rebecca E NelsonDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Ryan J LennonDivision of biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Lilach O LermanDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Sinsia GaoDepartment of Clinical Physiology, Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
Peter GanzDivision of Cardiology, San Francisco General Hospital, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA.
Li-Ming GanDepartment of Clinical Physiology, Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden; AstraZeneca R&D, Mölndal, Sweden. Electronic address: li-ming.gan@gu.se.
Amir LermanDivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. Electronic address: lerman.amir@mayo.edu.
Mayo Clinic in Arizona · USMayo Clinic · USAstraZeneca (Sweden) · SESahlgrenska University Hospital · SEUniversity of California, San Francisco · USUniversity of Gothenburg · SE

Funding

Lp-PLA2 and Coronary Atherosclerosis in HumansR01HL092954 · NHLBI · MAYO CLINIC ROCHESTER · PI LERMAN, AMIR · 2009 to 2013
$2.1M
Role of Endothelial Progenitor Cells in vascular Aging and CalcificationR01AG031750 · NIA · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP, LERMAN, AMIR · 2010 to 2014
$2.0M
NHLBI NIH HHS HL-92954NHLBI NIH HHS R01 HL092954NIA NIH HHS AG-31750NIA NIH HHS R01 AG031750
6 · The paper itself

Abstract

backgroundMyocardial perfusion scintigraphy (MPS) is used widely to assess cardiovascular risk in patients with chest pain. The utility of carotid intima-media thickness (CIMT) and endothelial function as assessed by reactive hyperemia-peripheral arterial tonometry index (RHI) in risk stratifying patients with angina-like symptoms needs to be defined. We investigated whether the addition of CIMT and RHI to Framingham Cardiovascular Risk Score (FCVRS) and MPS improves comprehensive cardiovascular risk prediction in patients presenting with angina-like symptoms.

methodsWe enrolled 343 consecutive patients with angina-like symptoms suspected of having stable angina. MPS, CIMT, and RHI were performed and patients were followed for cardiovascular events for a median of 5.3 years (range 4.4-6.2). Patients were stratified by FCVRS and MPS.

resultsDuring the follow-up, 57 patients (16.6%) had cardiovascular events. Among patients without perfusion defect, low RHI was significantly associated with cardiovascular events in the intermediate and high FCVRS groups (hazard ratio (HR) [95% confidence interval (CI)] of RHI ≤ 2.11 was 6.99 [1.34-128] in the intermediate FCVRS group and 6.08 [1.08-114] in the high FCVRS group). Furthermore, although MPS did not predict, only RHI predicted hard cardiovascular events (cardiovascular death, myocardial infarction, and stroke) independent from FCVRS, and adding RHI to FCVRS improved net reclassification index (20.9%, 95% CI 0.8-41.1, p = 0.04). Especially, RHI was significantly associated with hard cardiovascular events in the high FCVRS group (HR [95% CI] of RHI ≤ 1.93 was 5.66 [1.54-36.4], p = 0.007).

conclusionsPeripheral endothelial function may improve discrimination in identifying at-risk patients for future cardiovascular events when added to FCVRS-MPS-based risk stratification.

Indexed as

AgedAngina, StableCarotid Intima-Media ThicknessEndothelium, VascularFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRisk AssessmentRisk FactorsSingle-Blind MethodCardiovascular diseaseCarotid intima–media thicknessEndothelial functionFramingham Cardiovascular Risk ScoreMyocardial perfusionNoninvasive

Identifiers

PMID25918056
PMCPMC4673663
OpenAlexW2042700928

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.