HealthDay News — Mental stress-induced myocardial ischemia (MSIMI) is associated with increased risk of adverse cardiovascular events in patients with coronary artery disease (CAD), according to researchers.

“[MSIMI] has been associated with adverse prognosis in patients with [CAD], but whether this is a uniform finding across different studies has not been described,” wrote JingKai Wei, BM.S, of Emory University in Atlanta and colleagues.

A meta-analysis of five studies and a pooled sample with 555 patients were used to assess the association between MSIMI and adverse outcomes in patients with CAD (85% male). Outcomes of interest were CAD recurrence, CAD mortality, or total mortality. The researchers findings were published in The American Journal of Cardiology

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MSIMI was associated with an increased risk of the combined end point of cardiac events or total mortality (relative risk, 2.25; 95% CI: 15.9-3.15). No significant heterogeneity was found among the studies, reported the investigators.

“Although few selected studies have examined the association between MSIMI and adverse events in patients with CAD, all existing investigations point to approximately a doubling of risk,” concluded the researchers. “Whether this increased risk is generalizable to the CAD population at large and varies in patient subgroups warrant further investigation.”


  1. Wei J et al. The American Journal of Cardiology. 2014; doi: 10.1016/j.amjcard.2014.04.022