{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:52:26Z","timestamp":1793332346129,"version":"4.5.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Stark disparities in the outcome of myocardial infarction (MI) persist, with large unexplained variations affecting younger Black women. Mental stress\u2013induced myocardial ischemia (MSIMI) is an emerging mechanistic pathway that may help explain excess risks in this group. We sought to determine whether MSIMI is more common in Black women with recent premature MI than other demographic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We cross\u2010sectionally studied 602 individuals 61\u2009years and younger who were hospitalized for MI in the previous 8\u2009months. Participants underwent 99mTc\u2010sestamibi myocardial perfusion imaging at rest and after mental stress (speech task). A summed difference score was used to quantify ischemia. Clinically significant MSIMI was defined as a summed difference score \u22653. Log\u2010binomial and robust Poisson regression were used to adjust for sociodemographic, lifestyle, clinical, and psychosocial factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The mean age of patients was 51\u2009years (range, 25\u201361\u2009years), 46% were women, and 59% self\u2010identified as Black. Black women had a more adverse psychosocial profile and higher rates of obesity and diabetes but a less severe index MI. The incidence of MSIMI was approximately doubled in Black women than the other groups (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001 for interaction). Clinical and psychosocial risk factors did not explain these differences. In a fully adjusted model, the risk ratio of MSIMI for Black women was 2.2 (95% CI, 2.0\u20132.5) compared with Black men, 2.3 (95% CI, 1.8\u20132.9) compared with non\u2010Black women, and 1.8 (95% CI, 1.4\u20132.2) compared with non\u2010Black men.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among midlife individuals with a recent MI, Black women have a disproportionately higher risk of MSIMI. Targeted interventions for this high\u2010risk group are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044702","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:18:34Z","timestamp":1772101114000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Heightened Risk of Myocardial Ischemia With Mental Stress Among Black Women Survivors of a Myocardial Infarction in Midlife"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9054-0654","authenticated-orcid":false,"given":"Viola","family":"Vaccarino","sequence":"first","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]},{"name":"Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9099-9687","authenticated-orcid":false,"given":"Amit J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]},{"name":"Emory University School of Medicine","place":["Atlanta, USA"]},{"name":"Atlanta VA Medical Center","place":["Decatur, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-8931","authenticated-orcid":false,"given":"Ten\u00e9 T.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Piccinelli","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2307-6617","authenticated-orcid":false,"given":"Lisa","family":"Elon","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"She","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6543-9765","authenticated-orcid":false,"given":"Yi\u2010An","family":"Ko","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-312X","authenticated-orcid":false,"given":"Zachary T.","family":"Martin","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9333-3781","authenticated-orcid":false,"given":"Nancy","family":"Murrah","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6868-6956","authenticated-orcid":false,"given":"Lucy","family":"Shallenberger","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatum","family":"Roberts","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewam","family":"Stefanos","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Fan\u2010Lou","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-6433","authenticated-orcid":false,"given":"J. 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