What question did this study set out to answer?

The study aims to understand how coronary microvascular dysfunction (CMD) affects men and women and its influence on cardiac outcomes.

May 1, 2014CirculationOpen Access

Effects of Sex on Coronary Microvascular Dysfunction and Cardiac Outcomes

View Full Paper

Ask AI

Bookmark

Why the study?

Does coronary microvascular dysfunction predict major adverse cardiac events equally in men and women with suspected coronary artery disease but no visual evidence of obstructive disease?

Key Points

The study aims to understand how coronary microvascular dysfunction (CMD) affects men and women and its influence on cardiac outcomes.
Evaluated 405 men and 813 women with suspected coronary artery disease, no history of coronary artery disease, and normal myocardial perfusion imaging.
Quantified coronary flow reserve, defining CMD as coronary flow reserve <2.0 over a median follow-up of 1.3 years.
Assessed major adverse cardiac events using a blinded approach.
CMD prevalence was similar in men (51%) and women (54%) with no significant difference (Fisher exact test =0.39).
Coronary flow reserve was a strong predictor of major adverse cardiac events (HR 0.80, 95% CI 0.75-0.86, P<0.0001).
In a subgroup without coronary artery calcification, CMD was common (44% in men vs. 48% in women; Fisher exact test P=0.56).

Structured PICO

Does coronary microvascular dysfunction predict major adverse cardiac events equally in men and women with suspected coronary artery disease but no visual evidence of obstructive disease?

Population

1,218 patients (405 men and 813 women) referred for evaluation of suspected coronary artery disease with no previous history of coronary artery disease and no visual evidence of coronary artery disease on rest/stress positron emission tomography myocardial perfusion imaging.

Intervention

Assessment of coronary microvascular dysfunction (CMD), defined as coronary flow reserve <2.0 quantified by rest/stress positron emission tomography myocardial perfusion imaging.

Comparator

Patients without coronary microvascular dysfunction (coronary flow reserve ≥2.0), and comparison between sexes (men versus women).

Outcome

Major adverse cardiac events (composite of cardiac death, nonfatal myocardial infarction, late revascularization, and hospitalization for heart failure) assessed over a median follow-up of 1.3 years.composite

Coronary microvascular dysfunction is highly prevalent in both men and women with suspected CAD but normal perfusion imaging, and it strongly predicts major adverse cardiac events regardless of sex.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

CFR may refine risk stratification in suspected CAD without obstruction; leaves open whether microvascular-targeted interventions improve outcomes.

Cite This Study

Murthy et al. (2014) studied this question.

synapsesocial.com/papers/6a0a595aeda9b9caed96ae6b https://doi.org/10.1161/circulationaha.113.008507

Topics

Heart failure HFrEF treatment Coronary artery disease Women and heart disease

View Full Paper

Ask AI

Bookmark

Implication

CFR may refine risk stratification in suspected CAD without obstruction; leaves open whether microvascular-targeted interventions improve outcomes.

Effects of Sex on Coronary Microvascular Dysfunction and Cardiac Outcomes

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Effects of Sex on Coronary Microvascular Dysfunction and Cardiac Outcomes

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider