Key result
This state-of-the-art review highlights that acute myocardial infarction in patients without standard modifiable risk factors is driven by unique mechanisms and presents heterogeneous clinical outcomes.
Why the study?
Acute myocardial infarction in patients without standard modifiable risk factors is an increasingly recognized entity, but its true prevalence, pathogenesis, and heterogeneous outcomes remain poorly understood.
AMI in patients without standard modifiable risk factors is an increasingly recognized entity with unique underlying mechanisms and heterogeneous outcomes requiring further research.
SMuRF-less AMI patients warrant heightened acute vigilance; leaves open mechanistic and targeted therapeutic trials.
Acute myocardial infarction (AMI) in patients without standard modifiable risk factors (SMuRFs) is an increasingly recognized clinical entity. Traditionally, AMI has been closely associated with SMuRFs: hypertension, diabetes, dyslipidemia, and smoking. However, a subset of patients experience AMI without any of these established risk factors, posing diagnostic and therapeutic challenges. The true prevalence of AMI in SMuRF-less patients remains unclear, and the pathogenesis of coronary artery disease in these individuals is poorly understood. Current evidence suggests that unique mechanisms, including genetic predispositions and epigenetic modifications, inflammation, mental health and other non-traditional risk factors may contribute, though these remain to be clearly defined. Furthermore, the outcomes of SMuRF-less AMI present heterogeneity. In this review, we aim to examine the available literature on the underlying pathogenesis, potential causes of AMI in SMuRF-less patients, and their short- and long-term clinical outcomes compared to AMI patients with traditional risk factors. This knowledge could contribute to developing tailored treatment strategies and improving outcomes for this patient group.
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Moysidis et al. (2025) conducted a review in Acute myocardial infarction without standard modifiable risk factors (SMuRFs). Absence of standard modifiable risk factors (SMuRFs) vs. Presence of traditional risk factors was evaluated. This state-of-the-art review highlights that acute myocardial infarction in patients without standard modifiable risk factors is driven by unique mechanisms and presents heterogeneous clinical outcomes.
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