The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.
Excess Cardiovascular Risk in Women Relative to Men Referred for Coronary Angiography Is Associated With Severely Impaired Coronary Flow Reserve, Not Obstructive Disease
Open accessAbstract
Background: Cardiovascular disease (CVD) fatality rates are higher for women than for men, yet obstructive coronary artery disease (CAD) is less prevalent in women. Coronary flow reserve (CFR), an integrated measure of large- and small-vessel CAD and myocardial ischemia, identifies patients at risk for CVD death, but is not routinely measured in clinical practice. We sought to investigate the impact of sex, CFR, and angiographic CAD severity on adverse cardiovascular events. Methods: Consecutive patients (n=329, 43% women) referred for invasive coronary angiography after stress testing with myocardial perfusion positron emission tomography and with left ventricular ejection fraction >40% were followed (median, 3.0 years) for a composite end point of major adverse cardiovascular events, including cardiovascular death and hospitalization for nonfatal myocardial infarction or heart failure. The extent and severity of angiographic CAD were estimated by using the CAD prognostic index, and CFR was quantified by using positron emission tomography. Results: Although women in comparison with men had lower pretest clinical scores, rates of prior myocardial infarction, and burden of angiographic CAD ( P <0.001), they demonstrated greater risk of CVD events, even after adjustment for traditional risk factors, imaging findings, and early revascularization (adjusted hazard ratio, 2.05; 95% confidence interval, 1.05–4.02; P =0.03). Impaired CFR was similarly present among women and men, but in patients with low CFR (<1.6, n=163), women showed a higher frequency of nonobstructive CAD, whereas men showed a higher frequency of severely obstructive CAD ( P =0.002). After also adjusting for CFR, the effect of sex on outcomes was no longer significant. When stratified by sex and CFR, only women with severely impaired CFR demonstrated significantly increased adjusted risk of CVD events ( P <0.0001, P for interaction=0.04). Conclusions: Women referred for coronary angiography had a significantly lower burden of obstructive CAD in comparison with men but were not protected from CVD events. Excess cardiovascular risk in women was independently associated with impaired CFR, representing a hidden biological risk, and a phenotype less amenable to revascularization. Impaired CFR, particularly absent severely obstructive CAD, may represent a novel target for CVD risk reduction.
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Cites
Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504720 · Cited by 12,315
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A Novel Paradigm for Heart Failure With Preserved Ejection Fraction
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Efficacy and Safety of Alirocumab in Reducing Lipids and Cardiovascular Events
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Strategies for Multivessel Revascularization in Patients with Diabetes
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Cited by
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001168 · Cited by 1,598
Self-citationVirani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.04.003 · Cited by 596
Self-citationMurthy, V. L., Bateman, T. M., Beanlands, R. S., Berman, D. S., Borges-Neto, S., Chareonthaitawee, P., Cerqueira, M. D., deKemp, R. A., DePuey, E. G., Dilsizian, V., et al. (2018) · Journal of Nuclear Medicine · doi:10.2967/jnumed.117.201368 · Cited by 346
Self-citationGupta, A., Taqueti, V. R., van de Hoef, T. P., Bajaj, N. S., Bravo, P. E., Murthy, V. L., Osborne, M. T., Seidelmann, S. B., Vita, T., Bibbo, C. F., et al. (2017) · Circulation · doi:10.1161/circulationaha.117.029992 · Cited by 267
Self-citationTurner, M. E., Beck, L., Hill Gallant, K. M., Chen, Y., Moe, O. W., Kuro-o, M., Moe, S. M., & Aikawa, E. (2024) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.123.319198 · Cited by 54
Metadata
- Authors
- Taqueti, V. R., Shaw, L. J., Cook, N. R., Murthy, V. L., Shah, N. R., Foster, C. R., Hainer, J., Blankstein, R., Dorbala, S., & Di Carli, M. F.
- Venue
- Circulation
- Published
- 2017-02-07
- Volume
- 135
- Issue
- 6
- Pages
- 566-577
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2552901976
- Cited by
- 299
- References
- 48
- FWCI
- 24.97
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Taqueti, V. R., Shaw, L. J., Cook, N. R., Murthy, V. L., Shah, N. R., Foster, C. R., Hainer, J., Blankstein, R., Dorbala, S., & Di Carli, M. F. (2017). Excess Cardiovascular Risk in Women Relative to Men Referred for Coronary Angiography Is Associated With Severely Impaired Coronary Flow Reserve, Not Obstructive Disease. Circulation. https://doi.org/10.1161/circulationaha.116.023266
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
