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Incremental Impact of Standard Modifiable Cardiovascular Risk Factors on Long-Term Outcomes After Acute Myocardial

Shogo Okita1, Yuichi Saito1, Hiroaki Yaginuma1

  • 1Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan.

JACC. Asia
|May 6, 2026
PubMed
Abstract

Insights

The number of standard modifiable cardiovascular risk factors (SMuRFs) did not impact long-term outcomes after acute myocardial infarction (AMI). However, hypertension independently increased the risk of major adverse cardiovascular events (MACE) post-discharge.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Clinical Outcomes

Background:

  • Standard modifiable cardiovascular risk factors (SMuRFs) are linked to worse in-hospital outcomes in acute myocardial infarction (AMI).
  • The association between the number of SMuRFs and long-term outcomes post-AMI requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic impact of the number of SMuRFs on post-discharge outcomes in AMI patients.
  • To assess the relative prognostic importance of individual SMuRFs.

Main Methods:

  • Retrospective analysis of 2,059 AMI patients undergoing primary percutaneous coronary intervention.
  • Patients categorized by the number of SMuRFs (0-4).
  • Primary endpoint: major adverse cardiovascular events (MACE), including cardiovascular death, heart failure rehospitalization, recurrent AMI, and ischemic stroke.

Main Results:

  • Overall MACE risk did not differ significantly based on the number of SMuRFs.
  • An increasing number of SMuRFs was associated with a higher risk of recurrent AMI.
  • Hypertension was independently associated with an increased risk of MACE (adjusted HR: 1.629).

Conclusions:

  • The total number of SMuRFs did not significantly affect long-term cardiovascular risk after AMI discharge.
  • Hypertension emerged as a significant independent predictor of MACE in AMI survivors.
Keywords:
acute myocardial infarctiondiabetesdyslipidemiahypertensionsmoking

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