Evidence mapPaperPMID 41978343Full record

Trial reportEuropean heart journal. Quality of care & clinical outcomes2026

Sex differences in coronary disease health Status outcomes: the ISCHEMIA trial.

Anna Grodzinsky, Yoon J Cho, Philip G Jones, Leslee J Shaw, C Noel Bairey Merz, William E Boden, Gregg W Stone, Daniel B Mark, John A Spertus, David J Maron and 2 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in European heart journal. Quality of care & clinical outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01471522 (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
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.

NCT01471522 nacompletednot on this map

International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)

TypeinterventionalSponsorNYU Langone HealthRan2012 to 2023Enrolled5,179ConditionsCardiovascular Diseases, Coronary Disease, Coronary Artery Disease, Heart DiseasesArmscardiac catheterization, coronary artery bypass graft surgery, percutaneous coronary intervention, Lifestyle, Medication
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Anna GrodzinskySaint Luke's Mid America Heart Institute, Saint Luke's Muriel I. Kauffman Institute for Women's Cardiovascular Research, University of Missouri-Kansas City, Kansas City, MO 64110, USA.
Yoon J ChoSaint Luke's Mid America Heart Institute, Saint Luke's Muriel I. Kauffman Institute for Women's Cardiovascular Research, University of Missouri-Kansas City, Kansas City, MO 64110, USA.
Philip G JonesSaint Luke's Mid America Heart Institute, Saint Luke's Muriel I. Kauffman Institute for Women's Cardiovascular Research, University of Missouri-Kansas City, Kansas City, MO 64110, USA.
Leslee J ShawThe Zena and Michael A. Wiener Cardiovascular Institute, Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, NewYork, NY 10029, USA.
C Noel Bairey MerzBarbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA.
William E BodenVA New England Healthcare System, Boston, MA 01730, USA.
Gregg W StoneThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NewYork, NY 10029, USA.
Daniel B MarkDuke Clinical Research Institute, Durham, NC 27701, USA.
John A SpertusSaint Luke's Mid America Heart Institute, Kansas City, MO 64110, USA.
David J MaronDepartment of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Judith S HochmanCardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 530 First Avenue, HCC-4, NewYork, NY 10016, USA.
Harmony R ReynoldsCardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 530 First Avenue, HCC-4, NewYork, NY 10016, USA.ORCID 0000-0003-0284-0655

Funding

NHLBI NIH HHS U01 HL105462NHLBI NIH HHS U01HL105462NHLBI NIH HHS U01 HL105561NHLBI NIH HHS U01 HL105565NHLBI NIH HHS U01 HL105907NHLBI NIH HHS U01HL105907NIH U01HL105561NIH U01HL105565
6 · The paper itself

Abstract

aimsIn the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, women had worse angina than men despite less severe coronary artery disease (CAD) and ischaemia. We examined which patient and treatment factors might explain sex-based differences in angina. METHODS AND

resultsISCHEMIA randomized patients with moderate or severe ischaemia to an initial invasive strategy of cardiac catheterization with complete revascularization plus guideline-directed medical therapy (GDMT), or an initial conservative strategy of GDMT alone with invasive management reserved for GDMT failure. Coronary CT angiography was performed in most participants. Angina-related health status was collected at baseline and 1-year using the Seattle Angina Questionnaire (SAQ). Of 4617 ISCHEMIA participants with complete SAQ data, women averaged 6.5 points (95% CI 5.2 to 7.8) lower (worse) baseline SAQ-summary scores (SS) than men. This difference was not reduced by adjustment for demographics and clinical characteristics. Women had lower unadjusted 1-year SAQ-SS than men (Invasive -3.8 points, Conservative -5.7 points). These sex-based differences were attenuated but not eliminated by adjustment for baseline SAQ-SS. Adjustment for post-randomization treatment (GDMT intensity, risk factor goal achievement and, in the invasive strategy, complete revascularization) did not narrow the sex difference.

conclusionWomen with chronic CAD in ISCHEMIA had worse angina-related health status than men at baseline and 1-year. Differences were not explained by demographic or clinical characteristics, intensity of GDMT, or completeness of revascularization. It is thus important to consider other factors that may mediate these results, including differences in nociception, coronary microvascular dysfunction, and/or vasospasm.

trial registrationClinicalTrials.gov identifier: NCT01471522; https://clinicaltrials.gov/ct2/show/NCT01471522.

Indexed as

Angina PectorisCoronary Artery DiseaseHealth StatusMyocardial RevascularizationAgedCardiac CatheterizationComputed Tomography AngiographyCoronary AngiographyFemaleHumansMaleMiddle AgedSex FactorsAnginaCoronary heart diseasePatient provider communicationWomen

Identifiers

PMID41978343
PMCPMC13082453

What Socratic holds

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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.