Trial reportCirculation2018
Mental Stress-Induced-Myocardial Ischemia in Young Patients With Recent Myocardial Infarction: Sex Differences and Mechanisms.
Trial report in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 150 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
150 citing papers in PubMed, 4 syntheses or guidelines pooled it, 225 citations in OpenAlex.
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Clinical practice guideline of the Interamerican Society of Cardiology on primary prevention of cardiovascular disease in women.Archivos de cardiologia de Mexico · 2022Guideline
- A meta-analysis on the prevalence, associated factors and diagnostic methods of mental stress induced myocardial ischemia.Journal of translational medicine · 2020Pooled it
- Sex- and Gender-Stratified Risks of Psychological Factors for Incident Ischemic Heart Disease: Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2019Pooled it
- Objective Ischemia, Subjective Angina, and Psychological Distress in Angina With No Obstructive Coronary Disease.Journal of the American Heart Association · 2024Trial
- Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health: Findings From a Randomized Controlled Study.Journal of the American Heart Association · 2024Trial
- Development and assessment of scoring model for ICU stay and mortality prediction after emergency admissions in ischemic heart disease: a retrospective study of MIMIC-IV databases.Internal and emergency medicine · 2023Trial
- Effectiveness of Family-Centered Empowerment Model on Psychological Improvement of Patients With Myocardial Infarction: A Bayesian Multivariate Approach.Frontiers in public health · 2022Trial
- Modeling the Exposome in Murine Cardiovascular Disease.JACC. Basic to translational science · 2026Review
- Altered Neurovascular Coupling Dynamics During Dobutamine-Induced Acute Stress.Brain and behavior · 2026Article
- From protection to predisposition: A narrative review of sex-specific vascular responses to acute stressors across the lifespan.Physiological reports · 2026Review
- Anxiety and Depression in Women's Cardiovascular Health: Risk Modifiers, Mechanisms and Clinical Implications.Journal of cardiovascular development and disease · 2026Review
- Coronary microvascular dysfunction: a narrative review.Cardiovascular diagnosis and therapy · 2026Review
- Psychological Scars and Physical Consequences: Linking PTSD to Cardiovascular Health.Journal of cardiovascular translational research · 2026Review
- Acute coronary syndromes across the lifespan of women.NPJ cardiovascular health · 2026Review
- Depression, Anxiety, and Bipolar Disorder and Atherosclerosis.Current atherosclerosis reports · 2026Review
- Dose-dependent association between elevated resting IL-6 levels and severity of mental stress-induced myocardial perfusion defects.Psychological medicine · 2026Article
- Role of Exercise in Modulating the Brain-Heart Axis in Cardiovascular Diseases.International journal of molecular sciences · 2026Review
- Bidirectional brain-heart interactions in health and disease.Nature reviews. Neurology · 2026Review
- 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
90 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
20 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundMental stress-induced myocardial ischemia (MSIMI) is frequent in patients with coronary artery disease and is associated with worse prognosis. Young women with a previous myocardial infarction (MI), a group with unexplained higher mortality than men of comparable age, have shown elevated rates of MSIMI, but the mechanisms are unknown.
methodsWe studied 306 patients (150 women and 156 men) ≤61 years of age who were hospitalized for MI in the previous 8 months and 112 community controls (58 women and 54 men) frequency matched for sex and age to the patients with MI. Endothelium-dependent flow-mediated dilation and microvascular reactivity (reactive hyperemia index) were measured at rest and 30 minutes after mental stress. The digital vasomotor response to mental stress was assessed using peripheral arterial tonometry. Patients received
resultsThe mean age of the sample was 50 years (range, 22-61). In the MI group but not among controls, women had a more adverse socioeconomic and psychosocial profile than men. There were no sex differences in cardiovascular risk factors, and among patients with MI, clinical severity tended to be lower in women. Women in both groups showed a higher peripheral arterial tonometry ratio during mental stress but a lower reactive hyperemia index after mental stress, indicating enhanced microvascular dysfunction after stress. There were no sex differences in flow-mediated dilation changes with mental stress. The rate of MSIMI was twice as high in women as in men (22% versus 11%,
conclusionsYoung women after MI have a 2-fold likelihood of developing MSIMI compared with men and a similar increase in conventional stress ischemia. Microvascular dysfunction and peripheral vasoconstriction with mental stress are implicated in MSIMI among women but not among men, perhaps reflecting women's proclivity toward ischemia because of microcirculatory abnormalities.
Indexed as
Identifiers
What OpenQuestion holds
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.