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No standard modifiable cardiovascular risk factors in acute myocardial infarction: prevalence, pathophysiology, and
Yuichi Saito1, Kenichi Tsujita2, Yoshio Kobayashi3
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan. saitoyuichi1984@gmail.com.
Insights
Patients with acute myocardial infarction (MI) lacking standard modifiable cardiovascular risk factors (SMuRFs) have a surprisingly poor prognosis. This review explores the clinical relevance and mechanisms behind this phenomenon.
Area of Science:
- Cardiovascular Medicine
- Clinical Cardiology
- Atherosclerosis Research
Background:
- Standard modifiable cardiovascular risk factors (SMuRFs) like hypertension, diabetes, dyslipidemia, and smoking are established contributors to atherosclerotic cardiovascular diseases, including acute myocardial infarction (MI).
- Therapeutic strategies targeting SMuRFs are crucial for both primary and secondary prevention of cardiovascular diseases.
Purpose of the Study:
- To review the clinical evidence regarding the prevalence, pathophysiology, and prognosis of acute myocardial infarction (MI) patients who lack standard modifiable cardiovascular risk factors (SMuRFs).
- To explore potential underlying mechanisms contributing to the poorer outcomes observed in SMuRF-less acute MI patients.
Main Methods:
- Comprehensive literature review synthesizing existing clinical evidence.
- Analysis of studies investigating the characteristics and outcomes of acute MI patients with and without SMuRFs.
- Exploration of proposed pathophysiological explanations for the observed prognostic differences.
Main Results:
- A significant subset of acute myocardial infarction (MI) patients present without traditional standard modifiable cardiovascular risk factors (SMuRFs).
- Counterintuitively, the absence of SMuRFs in acute MI patients is associated with a poorer prognosis compared to those with identified risk factors.
- Emerging evidence suggests distinct pathophysiological pathways may be involved in SMuRF-less acute MI.
Conclusions:
- The lack of standard modifiable cardiovascular risk factors (SMuRFs) in acute myocardial infarction (MI) is a clinically relevant phenomenon associated with adverse outcomes.
- Further research into the unique pathophysiology and optimal management strategies for SMuRF-less acute MI patients is warranted.
- Understanding these patients is critical for improving overall cardiovascular disease prevention and treatment.
Abstract:
Standard modifiable cardiovascular risk factors (SMuRFs), such as hypertension, diabetes, dyslipidemia, and current smoking, are associated with the development of atherosclerotic cardiovascular diseases including acute myocardial infarction (MI). Thus, therapeutic approaches against SMuRFs are important as primary and secondary prevention of cardiovascular diseases. In patients with acute MI, however, the prognosis is counterintuitively poor when SMuRFs are lacking. The growing evidence has explored the prevalence, pathophysiology, and prognosis of SMuRF-less patients in acute MI and suggested the potential underlying mechanisms. This review article summarizes the clinical evidence and relevance of the lack of SMuRFs in acute MI.
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