Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/2782
Title: Prevalence and outcomes of patients with SMuRF-less acute coronary syndrome undergoing percutaneous coronary intervention.
Author: Ball, J.
Dinh, D.
Brennan, A.
Ajani, A.
Clark, D.
Freeman,M.
Oqueli, Ernesto
Hiew, C.
Nanayakkara, S.
Walton, A.
Shaw, J.
Chan, W.
Reid, C.
Stub, D.
Issue Date: 2024
Publication Title: Open Heart
Volume: 11
Issue: 1
Start Page: e002733
Abstract: Background: There is increasing awareness that patients without standard modifiable risk factors (SMuRFs; diabetes, hypercholesterolaemia, hypertension and smoking) may represent a unique subset of patients with acute coronary syndrome (ACS). We aimed to investigate the prevalence and outcomes of patients with SMuRF-less ACS undergoing percutaneous coronary intervention (PCI) compared with those with SMuRFs. Methods: We analysed data from the Melbourne Interventional Group PCI Registry. Patients with coronary artery disease were excluded. The primary outcome was 30-day mortality. Secondary outcomes included in-hospital and 30-day events. Long-term mortality was investigated using Cox-proportional hazards regression. Results: From 1 January 2005 to 31 December 2020, 2727/18 988 (14.4%) patients were SMuRF less, with the proportion increasing over time. Mean age was similar for patients with and without SMuRFs (63 years), and fewer females were SMuRF-less (19.8% vs 25.4%, p<0.001). SMuRF-less patients were more likely to present with cardiac arrest (6.6% vs 3.9%, p<0.001) and ST-elevation myocardial infarction (59.1% vs 50.8%, p<0.001) and were more likely to experience postprocedural cardiogenic shock (4.5% vs 3.6%, p=0.019) and arrhythmia (11.2% vs 9.9%, p=0.029). At 30 days, mortality, myocardial infarction, revascularisation and major adverse cardiac and cerebrovascular events did not differ between the groups. During median follow-up of 7 years, SMuRF-less patients had an adjusted 13% decreased rate of mortality (HR 0.87 (95% CI 0.78 to 0.97)). Conclusions: The proportion of SMuRF-less patients increased over time. Presentation was more often a devastating cardiac event compared with those with SMuRFs. No difference in 30-day outcomes was observed and SMuRF-less patients had lower hazard for long-term mortality.
URI: http://hdl.handle.net/11054/2782
DOI: https://doi.org/10.1136/openhrt-2024-002733
Internal ID Number: 02729
Health Subject: ACUTE CORONARY SYNDROME
PERCUTANEOUS CORONARY INTERVENTION
RISK FACTORS
Type: Journal Article
Article
Appears in Collections:Research Output

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