ArticleJournal of the American Heart Association2016
Sex Differences in Mental Stress-Induced Myocardial Ischemia in Patients With Coronary Heart Disease.
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 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.
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Who cites it
79 citing papers in PubMed, 1 synthesis or guideline pooled it, 119 citations in OpenAlex.
- What Do We Know About Young Adult Cardiac Patients' Experience? A Systematic Review.Frontiers in psychology · 2020Pooled it
- Sex Differences in Psychosocial Factors and Angina in Patients With Chronic Coronary Disease.Journal of the American Heart Association · 2025Trial
- Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer's disease.Translational psychiatry · 2024Trial
- Neighborhood poverty and hemodynamic, neuroendocrine, and immune response to acute stress among patients with coronary artery disease.Psychoneuroendocrinology · 2019Trial
- Mental Stress-Induced-Myocardial Ischemia in Young Patients With Recent Myocardial Infarction: Sex Differences and Mechanisms.Circulation · 2018Trial
- Mental stress as a trigger of cardiovascular events: A narrative review.European journal of clinical investigation · 2026Review
- Cardiomyocyte Glucocorticoid Receptors Exacerbate Stress Effects in Myocardial Ischemia Injury in Mice.Cells · 2025Article
- The Bidirectionality of Psychosocial Stress and Cardiovascular Disease Risk in Women; Recognition and Strategies for Management.Current atherosclerosis reports · 2025Review
- Real-life Psychological Experiences and Cardiac Autonomic Physiology among Survivors of a Myocardial Infarction in Midlife.Research square · 2025Article
- Psychosocial stress and cardiovascular disease.American journal of preventive cardiology · 2025Review
- A novel GWAS locus influences microvascular response to mental stress and predicts adverse cardiovascular events.Scientific reports · 2024Article
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 2024Review
- Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation.Open heart · 2024Article
- The Role of Psychosocial Stress on Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- Stress-Induced Autonomic Dysfunction is Associated With Mental Stress-Induced Myocardial Ischemia in Patients With Coronary Artery Disease.Circulation. Cardiovascular imaging · 2024Article
- Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan.Current atherosclerosis reports · 2024Review
- Glucocorticoids, their uses, sexual dimorphisms, and diseases: new concepts, mechanisms, and discoveries.Physiological reviews · 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
- Impact of Marital Stress on 1-Year Health Outcomes Among Young Adults With Acute Myocardial Infarction.Journal of the American Heart Association · 2023Observational
- Exposure to Stress Alters Cardiac Gene Expression and Exacerbates Myocardial Ischemic Injury in the Female Murine Heart.International journal of molecular sciences · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundEmerging data suggest that young women with coronary heart disease (CHD) are disproportionally vulnerable to the adverse cardiovascular effects of psychological stress. We hypothesized that younger, but not older, women with stable CHD are more likely than their male peers to develop mental stress-induced myocardial ischemia (MSIMI). METHODS AND
resultsWe studied 686 patients (191 women) with stable coronary heart disease (CHD). Patients underwent (99m)Tc-sestamibi myocardial perfusion imaging at rest and with both mental (speech task) and conventional (exercise/pharmacological) stress testing. We compared quantitative (by automated software) and visual parameters of inducible ischemia between women and men and assessed age as an effect modifier. Women had a more-adverse psychosocial profile than men whereas there were few differences in medical history and CHD risk factors. Both quantitative and visual indicators of ischemia with mental stress were disproportionally larger in younger women. For each 10 years of decreasing age, the total reversibility severity score with mental stress was 9.6 incremental points higher (interaction, P<0.001) and the incidence of MSIMI was 82.6% higher (interaction, P=0.004) in women than in men. Incidence of MSIMI in women ≤50 years was almost 4-fold higher than in men of similar age and older patients. These results persisted when adjusting for sociodemographic and medical risk factors, psychosocial factors, and medications. There were no significant sex differences in inducible ischemia with conventional stress.
conclusionsYoung women with stable CHD are susceptible to MSIMI, which could play a role in the prognosis of this group.
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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.