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Related Experiment Video

Updated: Feb 14, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Mortality After ST-Segment-Elevated Myocardial Infarction Among Patients With and Without Standard Modifiable

Bin Sun1, Chunpo Liang1, Pengfei Sun1

  • 1Department of Cardiology, Tianjin Medical University General Hospital, Tianjin Medical University, China (B.S., C.L., P.S., G.A., L.L., L.Z., P.L., Y.L., Q.Y., X.Z.).

Circulation. Population Health and Outcomes
|February 13, 2026
PubMed
Summary
This summary is machine-generated.

Patients without standard modifiable cardiovascular risk factors (SMuRF) undergoing ST-segment-elevation myocardial infarction treatment face higher 30-day mortality. This increased risk is confined to the initial month post-event, with no significant difference in later mortality.

Keywords:
Chinaacute coronary syndromecardiovascular diseasesmyocardial infarctionrisk factors

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Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • ST-segment-elevation myocardial infarction (STEMI) patients lacking standard modifiable cardiovascular risk factors (SMuRF) exhibit increased mortality.
  • Understanding the characteristics and outcomes of SMuRF-less STEMI patients is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the clinical features, treatments, and outcomes of STEMI patients without SMuRF.
  • To analyze the association between SMuRF-less status and mortality in a large, nationwide cohort.

Main Methods:

  • A nationwide, multicenter cohort study using data from the Chinese Cardiovascular Association Database-Chest Pain Center.
  • Inclusion of adult STEMI patients admitted between 2017-2021, defining SMuRF as hypertension, diabetes, hyperlipidemia, or smoking.
  • Assessment of all-cause mortality at 0-30 days and 31-365 days using multivariable Cox regression and landmark analysis.

Main Results:

  • 23.1% of 379,811 STEMI patients were SMuRF-less.
  • SMuRF-less patients had higher 30-day mortality (10.7% vs 6.7%), independently associated with increased risk (aHR, 1.22).
  • No significant difference in 31-365 day mortality was observed between groups (aHR, 1.00), with higher 30-day mortality more pronounced in men.

Conclusions:

  • Nearly a quarter of STEMI cases in China are SMuRF-less.
  • The excess mortality in SMuRF-less STEMI patients is primarily concentrated within the first 30 days post-admission.
  • Subsequent mortality rates do not differ significantly between SMuRF-less and SMuRF patients after the initial 30-day period.