AMI patients with ≥1 standard modifiable cardiovascular risk factor had a higher 3-year risk of MACCEs compared to SMuRF-less patients (HR 1.23; 95% CI 1.04-1.45).
Observational (n=21,173)
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Does the presence of standard modifiable cardiovascular risk factors (SMuRFs) worsen long-term outcomes in patients with acute myocardial infarction undergoing PCI?
In patients undergoing PCI for acute myocardial infarction, the presence of standard modifiable cardiovascular risk factors is associated with a significantly higher 3-year risk of major adverse cardiac and cerebrovascular events compared to SMuRF-less patients.
Hazard Ratio: 1.23 (95% CI 1.04–1.45)
Objective: To evaluate the prevalence and long-term clinical outcomes of patients presenting with acute myocardial infarction (AMI) without standard modifiable cardiovascular risk factors (SMuRFs) undergoing percutaneous coronary intervention (PCI), using a nationwide Korean registry. Design and method: We analyzed data from two nationwide, multicenter AMI registries in South Korea (KAMIR-NIH and KAMIR-V) between 2011 and 2020. Patients with AMI who underwent successful PCI were classified as SMuRF-less if they had none of the following risk factors: hypertension, diabetes mellitus, hypercholesterolemia, or current smoking. The primary endpoint was the 3-year incidence of major adverse cardiac and cerebrovascular events (MACCEs), defined as a composite of cardiac death, nonfatal myocardial infarction, unplanned revascularization, cerebrovascular accident, and unplanned admission for angina. Propensity score matching was performed to adjust for baseline differences between groups. Results: Among 21,173 patients included in the analysis, 2,165 (10.2%) were classified as SMuRF-less. Compared with patients with one or more SMuRFs, SMuRF-less patients were older, more frequently female, and had a lower prevalence of high Killip class at presentation. After propensity score matching, patients with 1 or more SMuRF exhibited a significantly higher risk of MACCEs over 3 years compared with SMuRF-less patients (hazard ratio 1.23, 95% confidence interval 1.04–1.45). Non-cardiac death and cardiovascular readmission occurred more frequently in the SMuRF group, whereas rates of cardiac death and nonfatal myocardial infarction were comparable between groups (Table 1).Conclusions: In this nationwide Korean registry, approximately one in ten patients with AMI undergoing PCI presented without SMrRFs. Despite comparable early clinical profiles, the presence of SMuRFs was associated with significantly worse long-term outcomes, as reflected by a higher incidence of MACCEs. These findings highlight the prognostic importance of traditional risk factors and the need for comprehensive long-term risk management after AMI.
Oh et al. (Fri,) conducted a observational in acute myocardial infarction (AMI) (n=21,173). 1 or more standard modifiable cardiovascular risk factors (SMuRFs) vs. SMuRF-less (no hypertension, diabetes mellitus, hypercholesterolemia, or current smoking) was evaluated on 3-year incidence of major adverse cardiac and cerebrovascular events (MACCEs) (HR 1.23, 95% CI 1.04-1.45). AMI patients with ≥1 standard modifiable cardiovascular risk factor had a higher 3-year risk of MACCEs compared to SMuRF-less patients (HR 1.23; 95% CI 1.04-1.45).