In-Hospital Mortality and Treatment in Patients With Acute Coronary Syndrome With and Without Standard Modifiable...

Area of Science:

• Cardiology
• Clinical Research
• Public Health

Background:

• Acute coronary syndrome (ACS) patients without standard modifiable cardiovascular risk factors (SMuRFs) are understudied.
• Limited data exists on their characteristics, care quality, and outcomes.

Purpose of the Study:

• To systematically analyze ACS patients without SMuRFs.
• To evaluate the effectiveness of guideline-directed medical therapy (GDMT) in this population.

Main Methods:

• Analysis of 89,462 patients from the CCC-ACS project (2014-2019).
• Categorization of patients based on the presence or absence of SMuRFs (hypertension, smoking, dyslipidemia, diabetes).
• Assessment of in-hospital all-cause mortality and GDMT receipt.

Main Results:

• 11.0% of ACS patients were SMuRF-less.
• SMuRF-less patients had higher in-hospital mortality (adjusted HR, 1.35).
• GDMT was not associated with lower mortality in SMuRF-less patients (adjusted HR, 0.98), unlike in patients with SMuRFs (adjusted HR, 0.80).

Conclusions:

• SMuRF-less ACS patients have an increased risk of in-hospital mortality.
• GDMT is less effective in SMuRF-less ACS patients compared to those with SMuRFs.
• Further studies are required to determine optimal therapies for SMuRF-less ACS patients.