ArticleJournal of thrombosis and thrombolysis2022
Long-term outcomes in acute coronary syndrome patients without standard modifiable risk factors: a multi-ethnic retrospective cohort study Of 5400 asian patients.
Article in Journal of thrombosis and thrombolysis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety.Cardiovascular diabetology · 2025Pooled it
- Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Pooled it
- Body composition phenotypes are key predictors of cardiovascular-kidney-metabolic multimorbidity and long-term mortality: insights from a population-based cohort study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Myocardial Infarction Without Standard Modifiable Risk Factors From 2025-2040: Forecast Analysis of Multinational, Population-Based Study.JACC. Asia · 2026Article
- Population estimates, trends, characteristics and prognostic outcomes of cardiovascular-kidney-liver-metabolic health: A population-based study.American journal of preventive cardiology · 2026Article
- Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction.Scientific reports · 2025Article
- Article
- A sex-disaggregated analysis of the prognostic value of lean type 2 diabetes mellitus in the adult population with acute myocardial infarction.Cardiovascular diabetology · 2025Article
- Prognostic value of the atherogenic index of plasma in patients with acute coronary syndrome without standard modifiable risk factors: a machine learning-based cohort study.Frontiers in cardiovascular medicine · 2025Article
- Prognostic value of serum glycated albumin in acute coronary syndrome patients without standard modifiable cardiovascular risk factors.Diabetology & metabolic syndrome · 2024Article
- No standard modifiable cardiovascular risk factors in acute myocardial infarction: prevalence, pathophysiology, and prognosis.Cardiovascular intervention and therapeutics · 2024Review
- Prognostic significance of triglyceride-glucose index in acute coronary syndrome patients without standard modifiable cardiovascular risk factors.Cardiovascular diabetology · 2024Observational
- Prevalence and outcomes of patients with SMuRF-less acute coronary syndrome undergoing percutaneous coronary intervention.Open heart · 2024Article
- Defining Outcomes in East Asian Elderly STEMI Patients Without Standard Modifiable Risk Factors.JACC. Asia · 2024Article
- Effect of Cardiovascular Risk Factors on 30-Day All-Cause Mortality in Cardiogenic Shock.Journal of clinical medicine · 2023Article
- Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study.Journal of thrombosis and thrombolysis · 2023Article
- Clinical characteristics, management, and 5-year survival compared between no standard modifiable risk factor (SMuRFless) and ≥ 1 SMuRF ACS cases: an analysis of 15,051 cases from Pakistan.BMC cardiovascular disorders · 2023Article
- Editorial: The heart of NAFLD.Frontiers in medicine · 2023Article
- General Public's knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population.Frontiers in medicine · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A sizeable number of patients without standard modifiable cardiovascular risk factors (SMuRFs), such as hypertension, diabetes, hypercholesterolemia and smoking, suffer from acute coronary syndrome (ACS). These SMuRF-less patients have high short-term morbidity and mortality. We compared both short- and long-term outcomes of SMuRF-less and SMuRF ACS patients in a multi-ethnic Asian cohort.This was a retrospective study of patients with first ACS from 2011 to 2017. The primary outcome was long-term all-cause mortality. Secondary outcomes were 30-day all-cause mortality, cardiac-mortality, unplanned cardiac readmission, cardiogenic shock, heart failure, and stroke. Subgroup analysis was carried out by sex and ACS type.Of 5400 patients, 8.6% were SMuRF-less. The median follow-up time was 6.3 years (interquartile range [IQR] 4.2-8.2 years). SMuRF-less patients were younger and tended to present with ST-segment elevation myocardial infarction (STEMI). They were more likely to require inotropic support, intubation, and have cardiac arrest. At 30 days, SMuRF-less patients had higher rates of all-cause mortality, cardiac-related mortality and cardiogenic shock, but lower rates of heart failure. At 6 years, all-cause mortality was similar in both groups (18.0% versus 17.1% respectively, p = 0.631). Kaplan-Meier curves showed increased early mortality in the SMuRF-less group, but the divergence in survival curves was no longer present in the long-term. The absence of SMuRF was an independent predictor of mortality, regardless of sex or ACS type.In a multi-ethnic cohort of patients with ACS, SMuRF-less patients were observed to have higher mortality than SMuRF patients during the early stages which was attenuated over time.
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