Mortality and Cardiovascular Outcomes in Patients Presenting With Non-ST Elevation Myocardial Infarction Despite No...

Area of Science:

• Cardiology
• Public Health

Background:

• A significant number of patients with ST-segment-elevation myocardial infarction (MI) lack standard modifiable cardiovascular risk factors (SMuRFs).
• These patients often experience worse 30-day outcomes compared to those with SMuRFs.

Purpose of the Study:

• To investigate the clinical presentation, management, and outcomes of patients with non-ST-segment-elevation MI (NSTEMI) who do not have SMuRFs.

Main Methods:

• Analysis of data from the Swedish MI registry (SWEDEHEART) between 2005 and 2018.
• Comparison of NSTEMI patients with and without SMuRFs (hypertension, diabetes, hypercholesterolemia, smoking) using Cox proportional hazard models.

Main Results:

• 11.2% of 99,718 NSTEMI patients had no SMuRFs.
• Patients without SMuRFs exhibited higher 30-day all-cause and cardiovascular mortality (HR 1.20 and 1.25, respectively).
• SMuRF-less patients received secondary prevention medications less frequently, particularly women.

Conclusions:

• Approximately 1 in 10 NSTEMI patients lack traditional risk factors.
• The elevated 30-day mortality in this group underscores the necessity for enhanced population-based MI prevention and equitable, evidence-based in-hospital treatment.