Myocardial infarction

Among young and middle-aged survivors of MI, peripheral microvascular dysfunction with mental stress is associated with major adverse CV events among women ...

Researchers used survival models for recurrent events to examine the association between vascular response to stress, defined as the difference between post-stress and resting values, and major adverse CV events. Researchers defined major adverse CV events as a composite index of CV death and first/recurring events for nonfatal MI and HF hospitalization. During a median follow-up of 4.3 years, 64 patients had 141 adverse CV events (first and repeated). “Future studies should explore the mechanistic links underlying these results, including, for example, cardiovascular physiology/reactivity, sympathetic activation, inflammation and neuroendocrine pathways.” These alterations can lead to a higher microvascular resistance with reduced coronary blood flow that is associated with ischemia and adverse cardiovascular events. “Coronary microvascular dysfunction consists of dysregulation of small coronary arteriole through endothelium-dependent and endothelium-independent mechanisms.