• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

ST-elevation myocardial infarctions in the absence of standard modifiable cardiovascular risk factors may have worse outcomes

byNeel MistryandTeddy Guo
June 25, 2021
in Cardiology, Chronic Disease, Emergency
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Patients without standard modifiable cardiovascular risk factors (SMuRFs) had a significantly higher all-cause mortality at 30 days after first presentation of STEMI.

2. Patients without SMuRFs were significantly less likely to receive statins, ACEIs, ARBs, or beta-blockers at discharge.

 Evidence Rating Level: 2 (Good)

Study Rundown: Standard modifiable cardiovascular risk factors (SMuRFs: smoking, hypertension, diabetes, and hypercholesterolemia) significantly increase the risk of ST-elevation myocardial infarction (STEMI). However, a notable proportion of patients with no previous symptoms and no modifiable risk factors (SMuRF-less) present with severe myocardial infarction. SMuRF-less patients are often overlooked in the provision of effective and timely care, resulting in preventable complications. This study aimed to analyze the short-term and long-term clinical outcomes for patients with first presentation STEMI without SMuRFs and those with at least one modifiable risk factor. The primary outcome was all-cause mortality at 30 days after STEMI, whereas secondary outcomes included cardiovascular mortality, heart failure, and myocardial infarction. According to study results, SMuRF-less patients had a significantly higher all-cause mortality rate at 30 days after first presentation. They were also less likely to receive statins, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockade (ARB), or beta-blockers at discharge. This study was strengthened by a longitudinal follow-up design as patient data was collected for up to 12 years after episode of STEMI. Overall, this study provides valuable insight into use of short-term pharmacotherapy during the acute post-infarct period, regardless of perceived risk.

Click to read the study in The Lancet

Relevant Reading: Coronary Angiography after Cardiac Arrest without ST-Segment Elevation

RELATED REPORTS

Merck’s Winrevair: Pulmonary arterial hypertension drug shows success ahead of schedule

Switching from ticagrelor to clopidogrel may demonstrate benefit in patients with large body mass index and prior myocardial infarction

Coronary CT-angiography-guided management improves outcomes in patients with stable chest pain

In-depth [retrospective cohort]: Between Jan 1, 2005, and May 25, 2018, 74 679 patients were assessed for inclusion into the study. Included patients were ≥18 years of age with suspected acute coronary syndrome and a hospital diagnosis of STEMI. Patients with a history of coronary artery disease (i.e., percutaneous coronary intervention, coronary artery bypass graft, or myocardial infarction) were excluded. Altogether, 62 048 patients (of which 9228 were SMuRF-less) were included in the analysis. Median age was similar between patients with SMuRFs (68 years, interquartile range [IQR] 59-78) and those without (69 years, IQR 60-78, p<0.0001).

Among SMuRF patients (n=52 820), common risk factors were hypertension (70.4%), hypercholesterolemia (48.4%), current smoking (32.6%), and diabetes (21.3%). SMuRF-less patients had a significantly lower LDL-C, body-mass index (BMI), HbA1c, systolic blood pressure, and heart rate than SMuRF patients. They were also less likely to receive statins, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockage (ARB), and B-blockers upon discharge. However, the rate of percutaneous coronary intervention was similar between both groups. The primary outcome of all-cause mortality at 30 days was significantly higher in SMuRF-less patients than SMuRF patients (hazard ratio [HF] 1.47, 95% confidence interval [CI] 1.37-1.57, p<0.0001). This was true after adjusting for age, sex, left ventricular ejection fraction, creatinine, and blood pressure. SMuRF-less patients had a significantly higher in-hospital mortality rate (n=883, 9.6%) than their counterparts (n=3411, 6.5%, p<0.0001). Secondary outcomes of myocardial infarction and heart failure at 30 days after STEMI were lower in SMuRF-less patients; although, all-cause mortality remained elevated in SMuRF-less men for more than 8 years and SMuRF-less women for more than 12 years. Findings from this study suggest that SMuRF-less STEMI patients have a higher risk of mortality than those with one or more standard risk factor.

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: acute coronary syndromeacute coronary syndrome (ACS)acute myocardial infarctionAngioplastycardiovascularcardiovascular diseasecardiovascular mortalitycardiovascular riskcoronary artery disease (CAD)coronary heart diseaseHeart Attack (Myocardial Infarction)myocardial infarctionmyocardial infarction (MI)percutaneous coronary interventionpercutaneous coronary intervention (PCI)STEMI
Previous Post

#VisualAbstract: Late cranial neuropathy incidence may increase with time among oropharyngeal squamous cell carcinoma survivors

Next Post

Increased mortality among parents of children with major congenital anomalies

RelatedReports

Pulmonary MRI with ultrashort echo time is comparable to pulmonary CT
Pharma

Merck’s Winrevair: Pulmonary arterial hypertension drug shows success ahead of schedule

March 25, 2025
Cardiology

Switching from ticagrelor to clopidogrel may demonstrate benefit in patients with large body mass index and prior myocardial infarction

March 22, 2025
Physician visual assessment of coronary stenosis severity overestimates quantitative coronary angiography
Cardiology

Coronary CT-angiography-guided management improves outcomes in patients with stable chest pain

March 12, 2025
Cardiology

Spironolactone ineffective for patients with preserved ejection fraction after myocardial infarction

March 4, 2025
Next Post

Increased mortality among parents of children with major congenital anomalies

Thrombophilia-associated stillbirth risk appears limited to factor V Leiden

P2Y12 inhibitor monotherapy after coronary stenting

#VisualAbstract Chlormethine gel shows importance in real-world therapeutics in combination with other therapies for mycosis fungoides cutaneous T-cell lymphoma

#VisualAbstract Chlormethine gel shows importance in real-world therapeutics in combination with other therapies for mycosis fungoides cutaneous T-cell lymphoma

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Reductions in pain catastrophizing are associated with improvements in emotional functioning
  • Repeated medial branch blocks do not improve pain outcomes for thermal radiofrequency ablation
  • Early screening for emotional and cognitive issues may improve psychiatric outcomes for stroke patients
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.