Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort.

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

BMC Medicine Pub Date : 2025-02-24 DOI:10.1186/s12916-025-03933-2

Zaixin Jiang, Haiwei Liu, Miaohan Qiu, Jing Li, Wei Zhao, Donghong Zhang, Daoshen Liu, Kun Na, Yi Li, Yaling Han

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引用次数: 0

Abstract

Background: Acute coronary syndrome (ACS) patients without standard modifiable cardiovascular risk factors (SMuRFs) have a higher risk of early mortality. However, little is known about their long-term outcomes, especially for patients undergoing percutaneous coronary intervention (PCI). This study aims to explore the long-term outcomes and identify independent factors associated with adverse clinical outcomes in patients with ACS undergoing PCI without SMuRFs.

Methods: This study used data from Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease (OPT-CAD) registry study. Clinical characteristics and outcomes of patients with and without SMuRFs were examined. The primary outcomes were major adverse cardia-cerebrovascular events (MACCE). The long-term (5 years) outcomes were compared between the without and with SMuRFs group in such cohort. An exploratory Cox proportional hazards regression was performed to identify the independent demographic and clinical predictors of the adverse clinical outcomes in the SMuRFs-absent cohort.

Results: Among 5688 patients with ACS undergoing PCI, 392 (6.9%) were in the absence of SMuRFs and 5296 (93.1%) were in the presence of SMuRFs. There were no significant differences in MACCE rates between the two cohorts (9.44% vs. 9.76%, log-rank P = 0.90). Cox proportional hazards regression indicated that age (HR, 1.06; 95% CI, 1.03-1.10; P = 0.001) and thrombus lesions (HR, 2.58; 95% CI, 1.24-5.40; P = 0.011) were independently associated with MACCE in the SMuRFs-absent cohort.

Conclusions: Among patients with ACS undergoing PCI, SMuRFs-absent patients had similar MACCE rates when compared with those with one or more SMuRFs at 5 years. This suggests that effective intervention strategies and updated risk assessment models are urgently needed in the SMuRFs-absent cohort.

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.