ArticleCoronary artery disease2016
Coronary endothelial function testing provides superior discrimination compared with standard clinical risk scoring in prediction of cardiovascular events.
Article in Coronary artery disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis 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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Cardiovascular Changes in Menopause.Current cardiology reviews · 2021Pooled it
- Electrocardiographic Predictors of Major Adverse Cardiovascular Events in Women With Suspected Ischemia and no Obstructive Coronary Artery Disease: Results of the Women's Ischemia Syndrome Evaluation.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Coronary Endothelial Dysfunction Is Associated With Major Depressive Disorder in Men With Chest Pain and Nonobstructive Coronary Artery Disease.Journal of the American Heart Association · 2026Article
- Navigating Cardiotoxicity in Cancer Treatment: Insights into Fluoropyrimidine-induced Cardiac Events.Current cardiology reviews · 2026Review
- Take charge during treatment: a protocol for a pilot study to evaluate the impact of exercise on cardiovascular biomarkers among black and white breast cancer patients undergoing treatment.Cardio-oncology (London, England) · 2025Article
- Severe multifocal coronary artery spasms after cessation of vasodilators in a patient with a spontaneous coronary artery dissection: a case report.European heart journal. Case reports · 2024Article
- Endothelial Dysfunction in Heart Failure: What Is Its Role?Journal of clinical medicine · 2024Review
- The Relationship of Left Ventricular Diastolic Dysfunction and Asymmetrical Dimethylarginine as a Biomarker of Endothelial Dysfunction with Cardiovascular Risk Assessed by Systematic Coronary Risk Evaluation2 Algorithm and Heart Failure-A Cross-Sectional Study.International journal of environmental research and public health · 2023Article
- Coronary microvascular dysfunction: A review of recent progress and clinical implications.Frontiers in cardiovascular medicine · 2023Review
- Vascular aging and cardiovascular disease: pathophysiology and measurement in the coronary arteries.Frontiers in cardiovascular medicine · 2023Review
- The Mechanism Study of Moxa Combustion Products on Regulating Vascular Endothelial Function in Atherosclerotic Mice.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Anxiety Disorders Are Associated With Coronary Endothelial Dysfunction in Women With Chest Pain and Nonobstructive Coronary Artery Disease.Journal of the American Heart Association · 2021Article
- Sweat the small stuff: The human microvasculature and heart disease.Microcirculation (New York, N.Y. : 1994) · 2021Review
- Invasive Diagnosis of Coronary Functional Disorders Causing Angina Pectoris.European cardiology · 2021Review
- Predicted Versus Observed Major Adverse Cardiac Event Risk in Women With Evidence of Ischemia and No Obstructive Coronary Artery Disease: A Report From WISE (Women's Ischemia Syndrome Evaluation).Journal of the American Heart Association · 2020Article
- Elevated renalase levels in patients with acute coronary microvascular dysfunction - A possible biomarker for ischemia.International journal of cardiology · 2019Article
- Rethinking Endothelial Dysfunction as a Crucial Target in Fighting Heart Failure.Mayo Clinic proceedings. Innovations, quality & outcomes · 2019Review
- European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection.European heart journal · 2018Article
- Ischemia and No Obstructive Coronary Artery Disease ( INOCA ): What Is the Risk?Journal of the American Heart Association · 2018Review
- Why names matter for women: MINOCA/INOCA (myocardial infarction/ischemia and no obstructive coronary artery disease).Clinical cardiology · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEndothelial dysfunction is regarded as the early stage of atherosclerosis and is associated with cardiovascular (CV) events. This study was designed to determine whether assessment of coronary endothelial function (CEF) is safe and can reclassify risk in patients with early coronary artery disease beyond the Framingham risk score (FRS). METHODS AND
resultsCEF was evaluated using intracoronary acetylcholine in 470 patients who presented with chest pain and nonobstructive coronary artery disease. CV events were assessed after a median follow-up of 9.7 years. The association between CEF and CV events was examined, and the net reclassification improvement index (NRI) was used to compare the incremental contribution of CEF when added to FRS.The mean age was 53 years, and 68% of the patients were women with a median FRS of 8. Complications (coronary dissection) occurred in three (0.6%) and CV events in 61 (13%) patients. In univariate analysis, microvascular CEF [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.72-0.97, P=0.032] and epicardial CEF (HR 0.73, 95% CI 0.59-0.90, P=0.01) were found to be significant predictors of CV events, whereas FRS was not (HR 1.05, 95% CI 0.85-1.26, P=0.61). When added to FRS, microvascular CEF correctly reclassified 11.3% of patients [NRI 0.11 (95% CI 0.019-0.21)], epicardial CEF correctly reclassified 12.1% of patients [NRI 0.12 (95% CI -0.02 to 0.26)], and the combined microvascular and epicardial CEF correctly reclassified 22.8% of patients [NRI 0.23 (95% CI 0.08-0.37)].
conclusionCEF testing is safe and adds value to the FRS, with superior discrimination and risk stratification compared with FRS alone in patients presenting with chest pain or suspected ischemia.
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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 Socratic graph.