Evidence map›Paper›PMID 26404195›Full record

ArticleJACC. Cardiovascular interventions2015

Effect of Sex Differences on Invasive Measures of Coronary Microvascular Dysfunction in Patients With Angina in the Absence of Obstructive Coronary Artery Disease.

Yuhei Kobayashi, William F Fearon, Yasuhiro Honda, Shigemitsu Tanaka, Vedant Pargaonkar, Peter J Fitzgerald, David P Lee, Marcia Stefanick, Alan C Yeung, Jennifer A Tremmel

Registry-linked trialOpen access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular interventions, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00823563 (Evaluation of Patients With Angina in the Absence of Obstructive Coronary Artery Disease), which is not on this map. Cited by 67 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 5 pooled it
6.8field-weighted citation impact, top 3% 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.

NCT00823563 recruitingnot on this map

Evaluation of Patients With Angina in the Absence of Obstructive Coronary Artery Disease

Typeobservational_patient_registrySponsorStanford UniversityRan2007 to 2047Enrolled2,000ConditionsChest Pain, IschemiaArms30 cc blood draw, Intravascular ultrasound (IVUS), Coronary pressure/flow wire testing, Coronary pressure/flow testing: Acetycholine challenge, Procedure: Coronary pressure/flow testing: Nitroglycerin challenge
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 5 syntheses or guidelines pooled it, 145 citations in OpenAlex.

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  7. Women's heart and echocardiography.Journal of cardiovascular imaging · 2026
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Yuhei KobayashiStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
William F FearonStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Yasuhiro HondaStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Shigemitsu TanakaStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Vedant PargaonkarStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Peter J FitzgeraldStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
David P LeeStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Marcia StefanickStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Alan C YeungStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California.
Jennifer A TremmelStanford Cardiovascular Institute and Stanford University Medical Center, Stanford, California. Electronic address: jtremmel@stanford.edu.
Cardiovascular Institute of the South · US

Funding

Sex Differences: Pathophysiology of Symptomatic Non-Obstructive Coronary DiseaseK23HL092233 · NHLBI · STANFORD UNIVERSITY · PI TREMMEL, JENNIFER ANN · 2009 to 2013
$680k
NHLBI NIH HHS K23 HL092233NHLBI NIH HHS K23 HL092233-05
6 · The paper itself

Abstract

objectivesThis study investigated sex differences in coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) in patients with angina in the absence of obstructive coronary artery disease.

backgroundCoronary microvascular dysfunction is associated with worse long-term outcomes, especially in women. Coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) are 2 methods of assessing the coronary microcirculation.

methodsWe prospectively enrolled 117 women and 40 men with angina in the absence of obstructive coronary artery disease. We performed CFR, IMR, fractional flow reserve, and quantitative coronary angiography in the left anterior descending artery. Coronary flow was assessed with a thermodilution method by obtaining mean transit time (Tmn) (an inverse correlate to absolute flow) at rest and hyperemia.

resultsAll patients had minimal atherosclerosis by quantitative coronary angiography (% diameter stenosis: 23.2 ± 12.3%), and epicardial disease was milder in women (fractional flow reserve: 0.88 ± 0.04 vs. 0.87 ± 0.04; p = 0.04). IMR was similar between the sexes (20.7 ± 9.8 vs. 19.1 ± 8.0; p = 0.45), but CFR was lower in women (3.8 ± 1.6 vs. 4.8 ± 1.9; p = 0.004). This was primarily due to a shorter resting Tmn in women (p = 0.005), suggesting increased resting coronary flow, whereas hyperemic Tmn was identical (p = 0.79). In multivariable analysis, female sex was an independent predictor of lower CFR and shorter resting Tmn.

conclusionsDespite similar microvascular function in women and men by IMR, CFR is lower in women. This discrepancy appears to be due to differences in resting coronary flow between the sexes. The effect of sex differences should be considered in interpretation of physiological indexes using resting coronary flow.

Indexed as

Cardiac CatheterizationFractional Flow Reserve, MyocardialHealth Status DisparitiesMicrocirculationAdultAgedAngina PectorisChi-Square DistributionCoronary AngiographyCoronary VesselsFemaleHumansMaleMicrovesselsMiddle AgedMultivariate Analysiscoronary flow reservecoronary microvascular resistancephysiologysex

Identifiers

PMID26404195
PMCPMC5292322
OpenAlexW1692191583

What OpenQuestion holds

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Read underepoch 390

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.