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Clinical Outcomes in Patients With ST-Segment Elevation MI and No Standard Modifiable Cardiovascular Risk Factors.

Gemma A Figtree¹, Bjorn Redfors², Rebecca Kozor³

¹Kolling Research Institute, University of Sydney, Sydney, Australia; Imaging and Phenotyping Laboratory, Charles Perkins Centre and Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

JACC. Cardiovascular Interventions

|June 9, 2022

Summary

Patients with ST-segment elevation myocardial infarction (STEMI) without standard modifiable cardiovascular risk factors (SMuRFs) had poorer pre-PCI flow. However, SMuRF-less status did not independently impact infarct size, ejection fraction, or mortality.

Keywords:

ST-segment elevation myocardial infarction atherosclerosis cardiovascular risk factors coronary artery disease

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Area of Science:

Cardiology
Cardiovascular Medicine
Interventional Cardiology

Background:

Previous reports indicated ~50% excess early mortality in STEMI patients lacking standard modifiable cardiovascular risk factors (SMuRFs).
The underlying reasons for this increased mortality in SMuRF-less STEMI patients remain unclear.

Purpose of the Study:

To investigate differences in infarct characteristics and clinical outcomes between STEMI patients with and without SMuRFs.
To analyze the impact of SMuRF status on infarct size, left ventricular ejection fraction, and mortality.

Main Methods:

Pooled individual-level data from 10 randomized percutaneous coronary intervention (PCI) trials.
Infarct size assessed by cardiac MRI or SPECT within one month.
STEMI patients categorized into SMuRF-less or SMuRF-present groups based on dyslipidemia, hypertension, diabetes, and smoking.

Main Results:

18.3% of 2,862 STEMI patients were SMuRF-less.
SMuRF-less patients exhibited a higher likelihood of poor pre-PCI Thrombolysis In Myocardial Infarction (TIMI) flow grade 0/1 (72.0% vs. 64.1%).
No significant associations were found between SMuRF-less status and infarct size, left ventricular ejection fraction, or 30-day/1-year mortality after adjustment.

Conclusions:

STEMI patients without baseline SMuRFs face an elevated risk of poor pre-PCI TIMI flow.
SMuRF-less status does not appear to be an independent predictor of infarct size, LV ejection fraction, or mortality in STEMI.