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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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