ArticleThe American journal of medicine2018
Chest Pain and Mental Stress-Induced Myocardial Ischemia: Sex Differences.
Article in The American journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 39 citations in OpenAlex.
- Sex differences in coronary disease health Status outcomes: the ISCHEMIA trial.European heart journal. Quality of care & clinical outcomes · 2026Trial
- Guanxin Danshen Dripping Pills Improve Quality of Life and Cardiovascular Prognoses of CHD Patients after PCI with Anxiety or Depression (GLAD Study): A Randomized Double-Blind Placebo-Controlled Study.Chinese journal of integrative medicine · 2023Trial
- Predicting recurrent chest pain in patients with myocardial bridging using explainable machine learning: a multicenter study integrating CT-derived functional and inflammatory imaging biomarkers.BMC medical imaging · 2026Article
- Distribution and morphology of CGRP-IR axons in flat-mounts of whole male and female mouse atria.Autonomic neuroscience : basic & clinical · 2025Article
- Myocardial blood flow mechanism of mental stress-induced myocardial ischemia in women with ANOCA.iScience · 2024Article
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 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
- A multimodal physiological and psychological dataset for human with mental stress induced myocardial ischemia.Scientific data · 2024Article
- The prognostic study of mental stress-induced myocardial ischemia in coronary revascularization patients with depression/anxiety: rationale and design.BMC cardiovascular disorders · 2023Article
- Establishment and effect evaluation of a stress cardiomyopathy mouse model induced by different doses of isoprenaline.Experimental and therapeutic medicine · 2023Article
- Predictors of critical illness among young males with chest pain, abdominal pain, or headaches in the Republic of Korea Army.Encephalitis (Seoul, Korea) · 2022Article
- Association between quality of life and mental stress-induced myocardial ischaemia in high-risk patients after coronary revascularization.Health and quality of life outcomes · 2022Article
- Psychiatry Meets Cardiology: A Case Report on the Need for Mental Health Assessment in the Evaluation of Cardiovascular Symptoms.Case reports in psychiatry · 2022Article
- Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient.Atherosclerosis · 2021Review
- Gender-Related Differences in Chest Pain Syndromes in the Frontiers in CV Medicine Special Issue: Sex & Gender in CV Medicine.Frontiers in cardiovascular medicine · 2021Review
- Psychometric properties of the Adulthood Trauma Inventory.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2020Article
- Association Between Mental Stress-Induced Inferior Frontal Cortex Activation and Angina in Coronary Artery Disease.Circulation. Cardiovascular imaging · 2020Article
- Cardiovascular Imaging of Biology and Emotion: Considerations Toward a New Paradigm.Circulation. Cardiovascular imaging · 2020Review
- Neural responses during acute mental stress are associated with angina pectoris.Journal of psychosomatic research · 2020Article
- Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation.European heart journal · 2020Article
Corrections and comments
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Authors and funding
16 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundMental stress-induced myocardial ischemia is a frequent phenomenon in patients with coronary artery disease. Women with coronary artery disease tend to have more mental stress-induced myocardial ischemia and more chest pain/anginal symptoms than men, but whether the association between mental stress-induced myocardial ischemia and angina burden differs in women and men is unknown.
methodsThis was a cross-sectional study with experimental manipulation of 950 individuals with stable coronary artery disease. Chest pain/angina frequency in the previous 4 weeks was assessed with the Seattle Angina Questionnaire's angina-frequency subscale. Mental stress-induced myocardial ischemia was assessed with myocardial perfusion imaging during mental stress (standardized public speaking task). Presence of mental stress-induced myocardial ischemia was based on expert readers and established criteria. A conventional (exercise or pharmacologic) stress test was used as a control condition.
resultsOverall, 338 individuals (37%) reported angina; 112 (12%) developed mental stress-induced myocardial ischemia, and 256 (29%) developed conventional stress ischemia. Women who reported angina had almost double the probability to develop mental stress-induced myocardial ischemia (19% vs 10%, adjusted prevalence rate ratio, 1.90; 95% confidence interval, 1.04-3.46), whereas there was no such difference in men (11% vs 11%, adjusted prevalence rate ratio, 1.09; 95% confidence interval, 0.66-1.82). No association was found between angina symptoms and conventional stress ischemia for women or men. Results for ischemia as a continuous variable were similar.
conclusionsIn women, but not in men, anginal symptoms may be a marker of vulnerability toward ischemia induced by psychologic stress. These results highlight the psychosocial origins of angina in women and may have important implications for the management and prognosis of women with angina.
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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.