Please use this identifier to cite or link to this item: https://doi.org/10.3389/fcvm.2022.876465
Title: Comparison of Mortality Outcomes in Acute Myocardial Infarction Patients With or Without Standard Modifiable Cardiovascular Risk Factors
Authors: Sia, Ching-Hui 
Ko, Junsuk
Zheng, Huili 
Ho, Andrew Fu-Wah 
Foo, David 
Foo, Ling-Li
Lim, Patrick Zhan-Yun
Liew, Boon Wah 
Chai, Ping 
Yeo, Tiong-Cheng 
Yip, James WL 
Chua, Terrance 
Chan, Mark Yan-Yee 
Tan, Jack Wei Chieh 
Figtree, Gemma
Bulluck, Heerajnarain
Hausenloy, Derek J 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
acute myocardial infarction
standard modifiable cardiovascular disease risk factors
STEMI
NSTEMI
mortality
SMuRF
IN-HOSPITAL MORTALITY
BODY-MASS INDEX
HEART-DISEASE
OBESITY
PATHOPHYSIOLOGY
OVERWEIGHT
MANAGEMENT
REGISTRY
WEIGHT
ADULTS
Issue Date: 14-Apr-2022
Publisher: FRONTIERS MEDIA SA
Citation: Sia, Ching-Hui, Ko, Junsuk, Zheng, Huili, Ho, Andrew Fu-Wah, Foo, David, Foo, Ling-Li, Lim, Patrick Zhan-Yun, Liew, Boon Wah, Chai, Ping, Yeo, Tiong-Cheng, Yip, James WL, Chua, Terrance, Chan, Mark Yan-Yee, Tan, Jack Wei Chieh, Figtree, Gemma, Bulluck, Heerajnarain, Hausenloy, Derek J (2022-04-14). Comparison of Mortality Outcomes in Acute Myocardial Infarction Patients With or Without Standard Modifiable Cardiovascular Risk Factors. FRONTIERS IN CARDIOVASCULAR MEDICINE 9. ScholarBank@NUS Repository. https://doi.org/10.3389/fcvm.2022.876465
Abstract: Background: Acute myocardial infarction (AMI) cases have decreased in part due to the advent of targeted therapies for standard modifiable cardiovascular disease risk factors (SMuRF). Recent studies have reported that ST-elevation myocardial infarction (STEMI) patients without SMuRF (termed "SMuRF-less") may be increasing in prevalence and have worse outcomes than "SMuRF-positive" patients. As these studies have been limited to STEMI and comprised mainly Caucasian cohorts, we investigated the changes in the prevalence and mortality of both SMuRF-less STEMI and non-STEMI (NSTEMI) patients in a multiethnic Asian population. Methods: We evaluated 23,922 STEMI and 62,631 NSTEMI patients from a national multiethnic registry. Short-term cardiovascular and all-cause mortalities in SMuRF-less patients were compared to SMuRF-positive patients. Results: The proportions of SMuRF-less STEMI but not of NSTEMI have increased over the years. In hospitals, all-cause and cardiovascular mortality and 1-year cardiovascular mortality were significantly higher in SMuRF-less STEMI after adjustment for age, creatinine, and hemoglobin. However, this difference did not remain after adjusting for anterior infarction, cardiopulmonary resuscitation (CPR), and Killip class. There were no differences in mortality in SMuRF-less NSTEMI. In contrast to Chinese and Malay patients, SMuRF-less patients of South Asian descent had a two-fold higher risk of in-hospital all-cause mortality even after adjusting for features of increased disease severity. Conclusion: SMuRF-less patients had an increased risk of mortality with STEMI, suggesting that there may be unidentified nonstandard risk factors predisposing SMuRF-less patients to a worse prognosis. This group of patients may benefit from more intensive secondary prevention strategies to improve clinical outcomes.
Source Title: FRONTIERS IN CARDIOVASCULAR MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/228398
ISSN: 2297055X
DOI: 10.3389/fcvm.2022.876465
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