SynthesisEuropean heart journal2022
Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis.
Synthesis in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06376630 (Study of Microvascular Dysfunction, Coronary Flow Reserve and Cardioprotective Effect of Early Intravenously Administration of Esmolol in Patients With Myocardial Infarction), which is not on this map. Cited by 142 papers, 4 of them syntheses 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.
Study of Microvascular Dysfunction, Coronary Flow Reserve and Cardioprotective Effect of Early Intravenously Administration of Esmolol in Patients With Myocardial Infarction
Who cites it
142 citing papers in PubMed, 4 syntheses or guidelines pooled it, 286 citations in OpenAlex.
- Efficacy and safety of combining commercial Chinese polyherbal preparation with conventional medicine in the treatment of coronary microvascular disease: a systematic review and network meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Comparative efficacy of commercial Chinese polyherbal preparation for coronary microvascular dysfunction: a systematic review and network meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2025Pooled it
- The prevalence of coronary microvascular dysfunction (CMD) in heart failure with preserved ejection fraction (HFpEF): a systematic review and meta-analysis.Heart failure reviews · 2024Pooled it
- The prognostic value of coronary flow reserve in patients with non-obstructive coronary artery disease and microvascular dysfunction: a systematic review and meta-analysis with focus on imaging modality and sex difference.The international journal of cardiovascular imaging · 2023Pooled it
- Heart Rate Variability Biofeedback and Mental Stress Myocardial Flow Reserve: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Coronary Microvascular Dysfunction Is Present Among Well-Treated Asymptomatic Persons With HIV and Similar to Those With Diabetes.Open forum infectious diseases · 2024Trial
- Dapagliflozin treatment is associated with a reduction of epicardial adipose tissue thickness and epicardial glucose uptake in human type 2 diabetes.Cardiovascular diabetology · 2023Trial
- Physiological assessment of coronary microvascular dysfunction and short-term outcomes in severely calcified coronary lesions: a comparison between rotational atherectomy and intravascular lithotripsy.Cardiovascular intervention and therapeutics · 2026Article
- Clinical Significance of High-Sensitivity Cardiac Troponin I and Myoglobin in Patients with Suspected Coronary Microvascular Dysfunction.Journal of cardiovascular translational research · 2026Article
- Prognostic incremental value of perivascular adipose tissue in myocardial infarction with non-obstructive coronary arteries: a multicenter cohort study.Quantitative imaging in medicine and surgery · 2026Article
- Review
- Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application.Cardiovascular intervention and therapeutics · 2026Review
- Correlation between intravascular pressure gradients and ultrasound velocities in carotid artery stenosis: An exploratory study.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Coronary Flow Reserve in Adults: Pathophysiology, Assessment Modalities, Clinical Applications, and Prognostic Significance.Medicina (Kaunas, Lithuania) · 2026Review
- Incremental Prognostic Power of Coronary Flow Reserve and Artificial Intelligence-Enabled ECG-Derived Filling Pressure in Angina With Nonobstructive Coronary Arteries.Journal of the American Heart Association · 2026Article
- Diagnostic performance of exercise stress testing findings and coronary microvascular dysfunction in patients with angina with non-obstructive coronary artery disease.Heart (British Cardiac Society) · 2026Article
- Beyond Stenosis: Mechanism-Based Multimodality Imaging and Invasive Coronary Function Testing for Endotype Definition in ANOCA/INOCA.Medicina (Kaunas, Lithuania) · 2026Review
- Primary myocardial involvement in systemic sclerosis: pathophysiology, clinical manifestations and advances in cardiac imaging.Rheumatology (Oxford, England) · 2026Review
- Multicenter Evaluation of Myocardial Flow Reserve as a Prognostic Marker for Mortality inCirculation. Cardiovascular imaging · 2026Article
- Chronic ischemic heart disease: A nonuniform syndrome.American heart journal plus : cardiology research and practice · 2026Review
82 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
Abstract
aimsThis meta-analysis aims to quantify the association of reduced coronary flow with all-cause mortality and major adverse cardiovascular events (MACE) across a broad range of patient groups and pathologies. METHODS AND
resultsWe systematically identified all studies between 1 January 2000 and 1 August 2020, where coronary flow was measured and clinical outcomes were reported. The endpoints were all-cause mortality and MACE. Estimates of effect were calculated from published hazard ratios (HRs) using a random-effects model. Seventy-nine studies with a total of 59 740 subjects were included. Abnormal coronary flow reserve (CFR) was associated with a higher incidence of all-cause mortality [HR: 3.78, 95% confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (HR 3.42, 95% CI: 2.92-3.99). Each 0.1 unit reduction in CFR was associated with a proportional increase in mortality (per 0.1 CFR unit HR: 1.16, 95% CI: 1.04-1.29) and MACE (per 0.1 CFR unit HR: 1.08, 95% CI: 1.04-1.11). In patients with isolated coronary microvascular dysfunction, an abnormal CFR was associated with a higher incidence of mortality (HR: 5.44, 95% CI: 3.78-7.83) and MACE (HR: 3.56, 95% CI: 2.14-5.90). Abnormal CFR was also associated with a higher incidence of MACE in patients with acute coronary syndromes (HR: 3.76, 95% CI: 2.35-6.00), heart failure (HR: 6.38, 95% CI: 1.95-20.90), heart transplant (HR: 3.32, 95% CI: 2.34-4.71), and diabetes mellitus (HR: 7.47, 95% CI: 3.37-16.55).
conclusionReduced coronary flow is strongly associated with increased risk of all-cause mortality and MACE across a wide range of pathological processes. This finding supports recent recommendations that coronary flow should be measured more routinely in clinical practice, to target aggressive vascular risk modification for individuals at higher risk.
Indexed as
Identifiers
What Socratic holds
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.