Evidence mapPaperPMID 36337036Full record

Observational studyEuropean heart journal2023

Coronary microvascular dysfunction is associated with impaired cognitive function: the Cerebral-Coronary Connection study (C3 study).

Hernan Mejia-Renteria, Alejandro Travieso, Jordi A Matías-Guiu, Miguel Yus, Carolina Espejo-Paeres, Francesca Finocchiaro, Sara Fernández, Carlos Ignacio Gomez-Escalonilla, Blanca Reneses-Prieto, Maria Dulcenombre Gómez-Garré and 10 more

Registry-linked trialOpen access · bronzeAbstract readObservational Study
In one paragraph

Observational study in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04131075 (Microcirculatory Dysfunction in Stable Coronary Artery Disease), which is not on this map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
6.4field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT04131075 unknown statusnot on this map

Microcirculatory Dysfunction in Stable Coronary Artery Disease: Relationship With Patient-focused Outcomes, Cerebral Small Vessel Disease and Depression.

TypeobservationalSponsorInstituto de Salud Carlos IIIRan2017 to 2020Enrolled100ConditionsIschemic Heart Disease, Microvascular Coronary Artery Disease, Depression, Endothelial DysfunctionArmsCoronary Angiography and Multimodal Coronary Physiology Study (FFR, CFR, HMR)
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 41 citations in OpenAlex.

  1. Article
  2. Review
  3. Observational
  4. Article
  5. Review
  6. Article
  7. Review
  8. Review
  9. Cognition and coronary events: A narrative overview of neurocognitive impairment in ACS patients.American heart journal plus : cardiology research and practice · 2025
    Review
  10. Review
  11. Review
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Systemic determinants of brain health in ageing.Nature reviews. Neurology · 2024
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 1 institution in 1 country.

Hernan Mejia-RenteriaInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.ORCID 0000-0003-1030-1926
Alejandro TraviesoInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.ORCID 0000-0003-3013-2592
Jordi A Matías-GuiuNeurology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.ORCID 0000-0001-5520-2708
Miguel YusRadiology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.ORCID 0000-0003-3191-6743
Carolina Espejo-PaeresInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.
Francesca FinocchiaroInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.
Sara FernándezInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.
Carlos Ignacio Gomez-EscalonillaNeurology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Blanca Reneses-PrietoPsychiatry Department, Hospital Clinico San Carlos IdISSC CIBERSAM, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Maria Dulcenombre Gómez-GarréMicrobiota and Cardiovascular Risk Laboratory CIBER CV, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.ORCID 0000-0002-5056-6489
Alfonso Delgado-AlvarezNeurology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Ana BustosRadiology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Leopoldo Perez de IslaCardiovascular Imaging Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Jose Juan Gomez de DiegoCardiovascular Imaging Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Javier Modrego-MartinMicrobiota and Cardiovascular Risk Laboratory CIBER CV, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.ORCID 0000-0002-2200-9503
Adriana Ortega-HernandezMicrobiota and Cardiovascular Risk Laboratory CIBER CV, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.ORCID 0000-0002-2654-4917
Petros PapadopoulosHematology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Juan Arrazola-GarcíaRadiology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Jorge Matías-GuiuNeurology Department, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Javier EscanedInterventional Cardiology Unit, Hospital Clinico San Carlos IdISSC, Universidad Complutense de Madrid, c/ Profesor Martín Lagos, s/n. 28240 Madrid, Spain.ORCID 0000-0003-4932-0112
Universidad Complutense de Madrid · ES

Funding

FEDERInstituto Carlos III
6 · The paper itself

Abstract

backgroundIt remains unknown whether the presence of coronary microcirculatory dysfunction (CMD) correlates with its equivalent condition in the brain, cerebral small vessel disease (CSVD). The cerebral-coronary connection (C3), a prospective blinded study, investigated the prevalence of CMD in patients with coronary artery disease (CAD) and its association with CSVD and cognitive function. METHODS AND

resultsPatients with documented CAD fulfilling inclusion criteria underwent physiological assessment of epicardial vessels and the microcirculation using intracoronary pressure and Doppler. Coronary microcirculation-related indices included coronary flow reserve (CFR) and hyperaemic microvascular resistance. Brain magnetic resonance imaging, transcranial Doppler (TCD), and neurocognitive examination were performed. Overall, 67 patients were included in the study (mean age 66 years, 73% female). Patients with abnormal CFR (<2.0) (55.2%) showed higher burden of white-matter hyperintensities: 43.2 vs. 20.0% (P = 0.044). After statistical adjustment, low CFR was associated with lower grey matter volume (P = 0.024) and with parameters of white-matter microstructural damage in diffusion-tensor imaging (lower fractional anisotropy and higher mean diffusivity, P = 0.029 and P = 0.032, respectively). Low CFR was associated with higher resistive (P = 0.027) and pulsatility (P = 0.043) values on TCD, and worse neurocognitive test scores (lower mini mental state examination, P = 0.025, and slower Trail Making Test A, P = 0.034).

conclusionsCoronary microcirculatory dysfunction is frequent in patients with CAD and correlates with CSVD, abnormal cerebral flow haemodynamics, and significant cognitive impairment. These findings support the hypothesis that microvascular dysfunction in the heart and the brain are part of a single pathological process affecting microcirculation in patients with CAD. CLINICAL

trial registrationClinicalTrials.gov NCT04131075.

Indexed as

Coronary Artery DiseaseFractional Flow Reserve, MyocardialHeart DiseasesMyocardial IschemiaAgedCognitionCoronary AngiographyCoronary VesselsFemaleHumansMaleMicrocirculationProspective StudiesVascular ResistanceCerebral small vessel diseaseCognitive impairmentCoronary microvascular dysfunctionIschaemic heart disease

Identifiers

PMID36337036
PMCPMC9825810
OpenAlexW4308364551

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.