ReviewEuropean cardiology2021
The Role of Mental Stress in Ischaemia with No Obstructive Coronary Artery Disease and Coronary Vasomotor Disorders.
Review in European cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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
21 citing papers in PubMed, 30 citations in OpenAlex.
- Randomized Controlled Trial of Internet-Delivered Cognitive Behavioral Therapy After Myocardial Infarction With Nonobstructive Coronary Arteries or Takotsubo Syndrome.Journal of the American Heart Association · 2026Trial
- Implementing a Smartphone and Wearable-Based Stress Management Intervention in Women With Coronary Artery Spasms to Reduce Cardiac Symptoms: Multicenter, Single-Arm, 1-Way Crossover Study.JMIR formative research · 2026Article
- Anxiety and Depression in Women's Cardiovascular Health: Risk Modifiers, Mechanisms and Clinical Implications.Journal of cardiovascular development and disease · 2026Review
- Dose-dependent association between elevated resting IL-6 levels and severity of mental stress-induced myocardial perfusion defects.Psychological medicine · 2026Article
- Higher anxiety score in patients with non-obstructive coronary artery disease.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2026Article
- From Intracoronary Physiology to Endotype-Based Treatment: Quality of Life Improvement for INOCA Patients.Journal of clinical medicine · 2025Article
- High Radial Artery Puncture Reduces CRPS Risk for Women: A Retrospective Case Series.Journal of clinical medicine · 2025Article
- The Relationship Between Cardiac Syndrome X and Obstructive Sleep Apnea and the Effects of Sleep Apnea Treatment on Myocardial Ischemia.Journal of clinical medicine · 2025Article
- Coronary microvascular dysfunction: pathophysiology, diagnosis, and therapeutic strategies across cardiovascular diseases.EXCLI journal · 2025Review
- Patients With Nonobstructive Coronary Artery Disease and Chest Pain: Impact of Obesity and Depressive Symptoms.Journal of the American Heart Association · 2024Article
- Beyond the Obstructive Paradigm: Unveiling the Complex Landscape of Nonobstructive Coronary Artery Disease.Journal of clinical medicine · 2024Review
- Review
- Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan.Current atherosclerosis reports · 2024Review
- Coronary Microvascular Dysfunction and Hypertension: A Bond More Important than We Think.Medicina (Kaunas, Lithuania) · 2023Review
- Lifetime ADHD symptoms highly prevalent in women with cardiovascular complaints. A cross-sectional study.Archives of women's mental health · 2023Article
- Symptom Presentation among Women with Suspected Ischemia and No Obstructive Coronary Artery Disease (INOCA).Journal of clinical medicine · 2023Article
- Review
- Sex Differences in Quality of Life in Patients with Ischemia with No Obstructive Coronary Artery Disease (INOCA): A Patient Self-Report Retrospective Survey from INOCA International.Journal of clinical medicine · 2023Article
- Clinical and psychological characteristics of patients with ischemia and non-obstructive coronary arteries (INOCA) and obstructive coronary artery disease.American heart journal plus : cardiology research and practice · 2023Article
- Position Statement on Women's Cardiovascular Health - 2022.Arquivos brasileiros de cardiologia · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ischaemic heart disease has been estimated to affect 126.5 million people globally. Approximately 70% of patients with angina and suspected myocardial ischaemia show no signs of obstructed coronary arteries after coronary angiography, but may still demonstrate ischaemia. Ischaemia with no obstructive coronary artery disease (INOCA) is increasingly acknowledged as a serious condition because of its association with poor quality of life and elevated risk for cardiovascular events. The negative effects of psychological stress on INOCA are gaining more attention. Psychological stress is associated with adverse cardiovascular outcomes such as mental stress-induced myocardial ischaemia. Psychological stress includes anxiety, depression, anger and personality disturbances. Coronary microvascular dysfunction and coronary arterial spasm are phenotypes of coronary vasomotor disorders that are triggered by psychological distress and depression, thereby increasing cardiovascular disease risk. Coronary vasomotor disorders are often co-existent in INOCA patients and might be considered as a contributing factor to mental stress-associated adverse cardiovascular outcomes. Additionally, psychological stress induces endothelial dysfunction more often in (young) women with INOCA than in men. Overall, many studies demonstrate an association between mental stress, coronary microvascular dysfunction and coronary vasospasm in patients with INOCA - especially women. Future research on stress-reducing therapies that target coronary vasomotor disorders in patients with INOCA is needed. This is particularly the case in young adolescents, in whom this type of ischaemic heart disease is increasing.
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Registered trials
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