SynthesisFrontiers in cardiovascular medicine2026
An updated meta-analysis of clinical outcomes, interventions, and treatment approaches in SMuRF vs. SMuRFless: evidence from 2.6 million ACS patients.
Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: SMuRFless patients with acute coronary syndrome lack traditional modifiable cardiovascular risk factors, however, concerns remain regarding their potentially poorer clinical outcomes. Methodology: This PRISMA-compliant meta-analysis was registered with PROSPERO (CRD420251021614). A single-arm meta-analysis was conducted to estimate the proportion of SMuRFless patients, while a random-effects frequentist meta-analysis compared SMuRFless vs. SMuRF patients. Statistical analyses were performed using R (version 2025.05.0 + 496; Posit). Results: Thirty studies comprising 2,650,310 patients were included, of whom 356,716 (13.5%) were SMuRFless. The pooled proportion of SMuRFless patients was 0.11 (95% CI, 0.09-0.14), with substantial heterogeneity ( Conclusion: SMuRFless patients represent a substantial minority of ACS patients and, despite fewer traditional risk factors, are characterized by distinct coronary anatomy and higher observed short-term adverse event rates. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251021614, identifier CRD420251021614.
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