ReviewJournal of the American College of Cardiology2023
Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors: JACC State-of-the-Art Review.
Abstract readReview
In one paragraph
Review in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 3 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 3 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
- Pooled it
- Commentary - genetic susceptibility as a risk enhancer in secondary prevention: Contextualizing the CAD polygenic risk score.American journal of preventive cardiology · 2026Article
- Utility of high-sensitivity cardiac troponin I normalized to left ventricular mass in detection of stable coronary artery disease.Nature cardiovascular research · 2026Article
- Improving Polygenic Risk Prediction for Atherosclerotic Cardiovascular Disease in East Asian Populations.JACC. Asia · 2026Review
- Myocardial Infarction Without Standard Modifiable Risk Factors From 2025-2040: Forecast Analysis of Multinational, Population-Based Study.JACC. Asia · 2026Article
- Risk Without Recognition: Anticipating the Rise of SMuRF-Less Myocardial Infarction.JACC. Asia · 2026Article
- How much does eliminating one or two cardiovascular risk factors matter?: Evidence from the Global Cardiovascular Risk Consortium.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Article
- Evaluating Individual Level Performance of Polygenic Risk Scores Using Early Onset High Genetic Risk Coronary Artery Disease as a Benchmark.medRxiv : the preprint server for health sciences · 2026Article
- Coronary Computed Tomography and Artificial Intelligence-based Plaque Analysis.Current atherosclerosis reports · 2026Review
- Obesity trajectories based on the European association for the study diagnostic framework and their associations with cardiovascular disease: evidence from two longitudinal cohorts.BMC public health · 2026Article
- Cardiovascular outcomes with icosapent ethyl by burden of standard modifiable cardiovascular risk factors in REDUCE-IT.American journal of preventive cardiology · 2026Article
- Arterial Thrombosis in Severe Ulcerative Colitis: A Case-Based Narrative Review of Current Evidence.Biomedicines · 2026Review
- Routine inflammatory indices modify clonal hematopoiesis-related prognostic risk in patients undergoing percutaneous coronary intervention: a real-world cohort study.BMC medicine · 2026Article
- C-reactive protein and cardiovascular risk among women with no standard modifiable risk factors: evaluating the 'SMuRF-less but inflamed'.European heart journal · 2026Article
- Association of Systemic Inflammation Indices With Mortality in Coronary Atherosclerosis Patients With and Without Standard Modifiable Risk Factors.Mediators of inflammation · 2026Article
- Beclin 1 level combined with Gensini score and low-density lipoprotein cholesterol correlate strongly with multi-vessel disease.American journal of translational research · 2026Article
- A Cross-Sectional Analytical Study: Prevalence and Clinical Profile of Metabolic Syndrome Among Middle Eastern, Mainly Jordanians, Cohort Presented with Atherosclerotic Cardiovascular Disease.Vascular health and risk management · 2026Observational
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
43 authors.
Gemma A FigtreeSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia. Electronic address: Gemma.figtree@sydney.edu.au.
Stephen T VernonSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Jason A HarmerDepartment of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia.
Michael P GraySydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia.
Clare ArnottThe George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Eric BachourConsumer Representative, Agile Group Switzerland AG, Zug, Switzerland.
Giannie BarshaSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia.
David BriegerDepartment of Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Alex BrownNational Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capitol Territory, Australia; Telethon Kids Institute, Nedlands, Western Australia, Australia.
David S CelermajerSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Keith M ChannonBritish Heart Foundation Centre of Research Excellence, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
Nicholas W S ChewDepartment of Cardiology, National University Heart Centre, National University Health System, Singapore.
James J H ChongWestmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia.
Clara K ChowWestmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia.
Peter A CistulliSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Patrick T EllinorCardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Boston, Massachusetts, USA.
Stuart M GrieveDepartment of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Imaging and Phenotyping Laboratory, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Tomasz J GuzikCentre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom; Department of Internal Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University Medical College, Krakow, Poland.
Emil HagströmDepartment of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Alicia JenkinsNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia; Diabetes and Vascular Medicine, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Garry JenningsSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Anthony C KeechNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Katharine A KottCardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Leonard KritharidesSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia; The ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Mamas A MamasKeele Cardiovascular Research Group, Centre for Prognostic Research, Keele University, Keele, United Kingdom; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom.
Roxana MehranThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Peter J MeikleBaker Heart and Diabetes Institute, Melbourne, Vicotria, Australia.
Pradeep NatarajanCardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
Kazuaki NegishiSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Department of Cardiology, Nepean Hospital, Kingswood, New South Wales, Australia.
John O'SullivanSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Precision Cardiovascular Laboratory, University of Sydney, Camperdown, New South Wales, Australia; Heart Research Institute, University of Sydney, Camperdown, New South Wales, Australia.
Sanjay PatelSydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Heart Research Institute, University of Sydney, Camperdown, New South Wales, Australia.
Peter J PsaltisVascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, SAHMRI, Adelaide, South Australia, Australia; Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Department of Cardiology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Julie RedfernThe George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Philippe G StegUniversité de Paris, Assistance Publique-Hôpitaux de Paris, French Alliance for Cardiovascular Trials and INSERM Unité 1148, Paris, France.
David R SullivanDepartment of Chemical Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Johan SundströmThe George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Birgit VogelThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Andrew WilsonMenzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Dennis WongMonash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia; MonashHeart, Monash Health, Clayton, Victoria, Australia.
Deepak L BhattMount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, New York, USA.
Jason C KovacicThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Stephen J NichollsVictorian Heart Institute, Monash University, Clayton, Victoria, Australia.
CRE for CAD Collaborators
Funding
IDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVALR01HL092577 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2009 to 2025
$20.6MUsing Electrocardiogram Genetics to Inform Arrhythmia RiskR01HL157635 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI ELLINOR, PATRICK THOMAS, MIRSHAHI, TOORAJ · 2022 to 2025
$2.9MBritish Heart Foundation CH/16/1/32013British Heart Foundation SP/17/16/33519NHLBI NIH HHS R01 HL092577NHLBI NIH HHS R01 HL157635
Abstract
Reducing the incidence and prevalence of standard modifiable cardiovascular risk factors (SMuRFs) is critical to tackling the global burden of coronary artery disease (CAD). However, a substantial number of individuals develop coronary atherosclerosis despite no SMuRFs. SMuRFless patients presenting with myocardial infarction have been observed to have an unexpected higher early mortality compared to their counterparts with at least 1 SMuRF. Evidence for optimal management of these patients is lacking. We assembled an international, multidisciplinary team to develop an evidence-based clinical pathway for SMuRFless CAD patients. A modified Delphi method was applied. The resulting pathway confirms underlying atherosclerosis and true SMuRFless status, ensures evidence-based secondary prevention, and considers additional tests and interventions for less typical contributors. This dedicated pathway for a previously overlooked CAD population, with an accompanying registry, aims to improve outcomes through enhanced adherence to evidence-based secondary prevention and additional diagnosis of modifiable risk factors observed.
Indexed as
AtherosclerosisCoronary Artery DiseaseMyocardial InfarctionCritical PathwaysHeart Disease Risk FactorsHumansatherosclerosiscardiovascular riskclinical pathwaycoronary artery diseaseprimary preventionsecondary prevention
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.