Kim JH, Almuwaqqat Z, Hammadah M, et al. - Researchers determined if adverse cardiovascular outcomes among patients with coronary artery disease (CAD) could be predicted by excessive digital vasoconstriction during acute mental stress. They performed mental stress testing with a standardized public speaking stressor on patients with stable CAD (n = 549, age 63 ± 9, 76% male, 29% Black). The participants were prospectively observed for cardiovascular endpoints. They computed stress/rest PAT ratio (sPAT) of pulse wave amplitude during mental stress/baseline and based on the median value, "low" and "high" sPAT ratio groups were defined. A follow-up of 3 years was performed. The median sPAT ratio was estimated to be 0.68, suggesting 32% vasoconstriction with mental stress. In patients with CAD, a higher risk of adverse cardiovascular outcomes was observed in correlation with greater peripheral vasoconstriction with mental stress, denoted by a low sPAT ratio.