Evidence map›Paper›PMID 31985803›Full record

ArticleEuropean heart journal. Cardiovascular Imaging2020

Increased long-term mortality in women with high left ventricular ejection fraction: data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) long-term registry.

Catherine Gebhard, Monika Maredziak, Michael Messerli, Ronny R Buechel, Fay Lin, Heidi Gransar, Stephan Achenbach, Mouaz H Al-Mallah, Daniele Andreini, Jeroen J Bax and 27 more

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

Article in European heart journal. Cardiovascular Imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01443637 (COronary CT Angiography Evaluation For Clinical Outcomes), which is not on this map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
2.4field-weighted citation impact, top 11% 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.

NCT01443637 completednot on this map

COronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter Registry

TypeobservationalSponsorWeill Medical College of Cornell UniversityRan2003 to 2016Enrolled34,000ConditionsAtherosclerosis, Coronary Artery Disease, Cardiovascular Disease
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 42 citations in OpenAlex.

  1. Trial
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  3. Echocardiographic strain imaging and progression of atrial fibrillation in low-risk individuals.International journal of cardiology. Heart & vasculature · 2026
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  15. Imaging of heart disease in women: review and case presentation.European journal of nuclear medicine and molecular imaging · 2022
    Review
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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

37 authors at 20 institutions in 11 countries.

Catherine GebhardDepartment of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Monika MaredziakDepartment of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Michael MesserliDepartment of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Ronny R BuechelDepartment of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Fay LinDalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 1300 York Avenue, New York, NY 10065, USA.
Heidi GransarDepartment of Imaging, Cedars-Sinai Medical Center, 8705 Gracie Allen Dr, Los Angeles, CA 90048, USA.
Stephan AchenbachDepartment of Cardiology, Friedrich-Alexander-University Erlangen-Nuremberg, Maximiliansplatz 2, 91054 Erlangen, Germany.
Mouaz H Al-MallahKing Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, Ministry of National Guard, Health Affairs, Ar Rimayah, Riyadh 14611, Saudi Arabia.
Daniele AndreiniCentro Cardiologico Monzino, IRCCS Milan, Via Carlo Parea, 4, 20138 Milan, Italy.
Jeroen J BaxDepartment of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, The Netherlands.
Daniel S BermanDepartment of Imaging and Medicine, Cedars Sinai Medical Center, 8705 Gracie Allen Dr, Los Angeles, CA, USA.
Matthew J BudoffDepartment of Medicine, Los Angeles Biomedical Research Institute, 1124 W Carson St, Torrance, CA 90502, USA.
Filippo CademartiriCardiovascular Imaging Center, SDN IRCCS, via Gianturco 113, 80143 Naples, Italy.
Tracy Q CallisterTennessee Heart and Vascular Institute, 353 New Shackle Island Rd, Hendersonville, TN 37075, USA.
Hyuk-Jae ChangDivision of Cardiology, Severance Cardiovascular Hospital, Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, South Korea.
Kavitha ChinnaiyanDepartment of Cardiology, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USA.
Benjamin J W ChowDepartment of Medicine and Radiology, University of Ottawa, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
Ricardo C CuryDepartment of Radiology, Miami Cardiac and Vascular Institute, 8900 N Kendall Dr, Miami, FL 33176, USA.
Augustin DeLagoCapitol Cardiology Associates, Corporate Woods 7 Southwoods Blvd., Albany, NY 12211, USA.
Gudrun FeuchtnerDepartment of Radiology, Medical University of Innsbruck, Christoph-Probst-Platz 1, Innrain 52, 6020 Innsbruck, Austria.
Martin HadamitzkyDepartment of Radiology and Nuclear Medicine, German Heart Center Munich, Lazarettstraße 36, 80636 Munich, Germany.
Joerg HausleiterMedizinische Klinik I der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany.
Yong-Jin KimSeoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, South Korea.
Jonathon LeipsicDepartment of Medicine and Radiology, University of British Columbia, 2775 Laurel St, Vancouver, BC V5Z 1M9, Canada.
Erica MaffeiDepartment of Radiology, Area Vasta 1/ASUR Marche, Viale Federico Comandino, 70, 61029 Urbino, Italy.
Hugo MarquesUNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisboa, Portugal.
Pedro de Araújo GonçalvesUNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisboa, Portugal.
Gianluca PontoneCentro Cardiologico Monzino, IRCCS Milan, Via Carlo Parea, 4, 20138 Milan, Italy.
Gilbert L RaffDepartment of Cardiology, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USA.
Ronen RubinshteinDepartment of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa 34362, Israel.
Leslee J ShawDalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 1300 York Avenue, New York, NY 10065, USA.
Todd C VillinesCardiology Service, Walter Reed National Military Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
Yao LuDepartment of Healthcare Policy and Research, New York-Presbyterian Hospital and the Weill Cornell Medical College, 402 E. 67th Street, New York, NY 10065, USA.
Erica C JonesDalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 1300 York Avenue, New York, NY 10065, USA.
Jessica M PeñaDalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 1300 York Avenue, New York, NY 10065, USA.
James K MinDalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 1300 York Avenue, New York, NY 10065, USA.
Philipp A KaufmannDepartment of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
NewYork–Presbyterian Hospital · USUniversity Hospital of Zurich · CHBeaumont Hospital, Royal Oak · USCedars-Sinai Medical Center · USCentro Cardiologico Monzino · ITHospital da Luz · PTUniversity of Zurich · CHCapital Cardiology Associates · USDeutsches Herzzentrum München · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DEInnsbruck Medical University · ATKing Saud bin Abdulaziz University for Health Sciences · SALeiden University Medical Center · NLLudwig-Maximilians-Universität München · DESDN Istituto di Ricerca Diagnostica e Nucleare · ITSeoul National University Hospital · KRTechnion – Israel Institute of Technology · ILThe Cardiac and Vascular Institute · USThe Lundquist Institute · USUniversity of British Columbia · CA

Funding

Gender-Specific Coronary Plaque Characteristics and Risk of Myocardial InfarctionR01HL115150 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI MIN, JAMES K · 2012 to 2016
$3.5M
NHLBI NIH HHS R01 HL115150
6 · The paper itself

Abstract

aimsThere are significant sex-specific differences in left ventricular ejection fraction (LVEF), with a higher LVEF being observed in women. We sought to assess the clinical relevance of an increased LVEF in women and men. METHODS AND

resultsA total of 4632 patients from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry (44.8% women; mean age 58.7 ± 13.2 years in men and 59.5 ± 13.3 years in women, P = 0.05), in whom LVEF was measured by cardiac computed tomography, were categorized according to LVEF (low <55%, normal 55-65%, and high >65%). The prevalence of high LVEF was similar in both sexes (33.5% in women and 32.5% in men, P = 0.46). After 6 years of follow-up, no difference in mortality was observed in patients with high LVEF in the overall cohort (P = 0.41). When data were stratified by sex, women with high LVEF died more often from any cause as compared to women with normal LVEF (8.6% vs. 7.1%, log rank P = 0.032), while an opposite trend was observed in men (5.8% vs. 6.8% in normal LVEF, log rank P = 0.89). Accordingly, a first order interaction term of male sex and high LVEF was significant (hazard ratios 0.63, 95% confidence intervals 0.41-0.98, P = 0.043) in a Cox regression model of all-cause mortality adjusted for age, cardiovascular risk factors, and severity of coronary artery disease (CAD).

conclusionIncreased LVEF is highly prevalent in patients referred for evaluation of CAD and is associated with an increased risk of death in women, but not in men. Differentiating between normal and hyperdynamic left ventricles might improve risk stratification in women with CAD. CLINICAL

trial registrationhttps://clinicaltrials.gov/ct2/show/NCT01443637.

Indexed as

Computed Tomography AngiographyCoronary Artery DiseaseAgedCoronary AngiographyFemaleHumansMaleMiddle AgedPrognosisProspective StudiesRegistriesSeverity of Illness IndexStroke VolumeVentricular Function, Leftcardiovascularcoronary computed tomography angiographygenderleft ventricular ejection fractionwomen

Identifiers

PMID31985803
PMCPMC7778362
OpenAlexW3003548070

What OpenQuestion holds

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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.