Ayman J Hammoudeh, Mo'men Aldalal'ah, Elham A Smadi, Dima Alrishoud, Amal Alomari, Mahmoud Alkhawaldeh, Aseel Rizik, Mahmoud Fakhri Okour, Mohammad Araydah
{"title":"中东动脉粥样硬化性心血管疾病患者缺乏标准可改变的危险因素。约旦缺乏标准可改变危险因素（SMuRF-Less）研究。","authors":"Ayman J Hammoudeh, Mo'men Aldalal'ah, Elham A Smadi, Dima Alrishoud, Amal Alomari, Mahmoud Alkhawaldeh, Aseel Rizik, Mahmoud Fakhri Okour, Mohammad Araydah","doi":"10.2147/VHRM.S499355","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A growing number of individuals develop atherosclerotic cardiovascular disease (ASCVD) despite the absence of the standard modifiable risk factors (hypertension, diabetes, dyslipidemia, and cigarette smoking) (SMuRF-less patients). Prevalence of SMuRF-less patients in the Middle East has not been studied. This study investigates the prevalence, clinical profiles and outcomes of SMuRF-less patients compared with those who have SMuRFs.</p><p><strong>Methods: </strong>We analyzed data from 6 published registries and from the Jordan SMuRF-less patients study, including baseline demographic features, cardiovascular risk factors, comorbid diseases, utilization of secondary prevention pharmacotherapy and one year outcome in SMuRF-less patients, those with 1-2 SMuRFs and with 3-4 SMuRFs. Results. A total of f 5540 ASCVD patients were enrolled. Mean age was 57.5 ± 11.6 years, and 1333 (24.1%) were women. Of the whole group, 214 (3.9%) were SMuRF-less, 3014 (54.4%) had 1-2 SMuRFs and 2312 (41.7%) had 3-4 SMuRFs. Compared with the SMuRFs groups, SMuRF-less group were younger, more likely to be men, and had lower prevalence of obesity, physical inactivity, metabolic syndrome, heart failure and chronic kidney disease. SMuRF-less patients were less likely to receive secondary prevention cardiovascular medications (antiplatelet agents, statins, renin angiotensin blockers and beta blockers); all p < 0.001. One year survival in the SMuRF-less patients was significantly lower than that in the SMuRFs groups (97.7% vs.98.4% vs.98.3%, respectively, p = 0.01). Multivariate analysis showed that young age, absence of heart failure and utilization of secondary preventive medications were associated with better one year outcome.</p><p><strong>Conclusion: </strong>In this cohort of ME patients with ASCVD, nearly four in 100 were SMuRF-less. This rate is lower than that reported by most of published studies, mainly due to the high prevalence of the 4 SMuRFs. SMuRF-less patients were younger, had less comorbid disease, received less secondary prevention pharmacotherapy and had higher rate of one year mortality than those with SMuRFs.</p><p><strong>Clinical trials: </strong>The study is registered with ClinicalTrials.gov, unique identifier number NCT06199869.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"39-50"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807772/pdf/","citationCount":"0","resultStr":"{\"title\":\"Absence of Standard Modifiable Risk Factors in Middle Eastern Patients with Atherosclerotic Cardiovascular Disease. The Jordan Absence of Standard Modifiable Risk Factors (SMuRF-Less) Study.\",\"authors\":\"Ayman J Hammoudeh, Mo'men Aldalal'ah, Elham A Smadi, Dima Alrishoud, Amal Alomari, Mahmoud Alkhawaldeh, Aseel Rizik, Mahmoud Fakhri Okour, Mohammad Araydah\",\"doi\":\"10.2147/VHRM.S499355\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A growing number of individuals develop atherosclerotic cardiovascular disease (ASCVD) despite the absence of the standard modifiable risk factors (hypertension, diabetes, dyslipidemia, and cigarette smoking) (SMuRF-less patients). Prevalence of SMuRF-less patients in the Middle East has not been studied. This study investigates the prevalence, clinical profiles and outcomes of SMuRF-less patients compared with those who have SMuRFs.</p><p><strong>Methods: </strong>We analyzed data from 6 published registries and from the Jordan SMuRF-less patients study, including baseline demographic features, cardiovascular risk factors, comorbid diseases, utilization of secondary prevention pharmacotherapy and one year outcome in SMuRF-less patients, those with 1-2 SMuRFs and with 3-4 SMuRFs. Results. A total of f 5540 ASCVD patients were enrolled. Mean age was 57.5 ± 11.6 years, and 1333 (24.1%) were women. Of the whole group, 214 (3.9%) were SMuRF-less, 3014 (54.4%) had 1-2 SMuRFs and 2312 (41.7%) had 3-4 SMuRFs. Compared with the SMuRFs groups, SMuRF-less group were younger, more likely to be men, and had lower prevalence of obesity, physical inactivity, metabolic syndrome, heart failure and chronic kidney disease. SMuRF-less patients were less likely to receive secondary prevention cardiovascular medications (antiplatelet agents, statins, renin angiotensin blockers and beta blockers); all p < 0.001. One year survival in the SMuRF-less patients was significantly lower than that in the SMuRFs groups (97.7% vs.98.4% vs.98.3%, respectively, p = 0.01). Multivariate analysis showed that young age, absence of heart failure and utilization of secondary preventive medications were associated with better one year outcome.</p><p><strong>Conclusion: </strong>In this cohort of ME patients with ASCVD, nearly four in 100 were SMuRF-less. This rate is lower than that reported by most of published studies, mainly due to the high prevalence of the 4 SMuRFs. SMuRF-less patients were younger, had less comorbid disease, received less secondary prevention pharmacotherapy and had higher rate of one year mortality than those with SMuRFs.</p><p><strong>Clinical trials: </strong>The study is registered with ClinicalTrials.gov, unique identifier number NCT06199869.</p>\",\"PeriodicalId\":23597,\"journal\":{\"name\":\"Vascular Health and Risk Management\",\"volume\":\"21 \",\"pages\":\"39-50\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-02-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807772/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vascular Health and Risk Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/VHRM.S499355\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular Health and Risk Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/VHRM.S499355","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Absence of Standard Modifiable Risk Factors in Middle Eastern Patients with Atherosclerotic Cardiovascular Disease. The Jordan Absence of Standard Modifiable Risk Factors (SMuRF-Less) Study.
Background: A growing number of individuals develop atherosclerotic cardiovascular disease (ASCVD) despite the absence of the standard modifiable risk factors (hypertension, diabetes, dyslipidemia, and cigarette smoking) (SMuRF-less patients). Prevalence of SMuRF-less patients in the Middle East has not been studied. This study investigates the prevalence, clinical profiles and outcomes of SMuRF-less patients compared with those who have SMuRFs.
Methods: We analyzed data from 6 published registries and from the Jordan SMuRF-less patients study, including baseline demographic features, cardiovascular risk factors, comorbid diseases, utilization of secondary prevention pharmacotherapy and one year outcome in SMuRF-less patients, those with 1-2 SMuRFs and with 3-4 SMuRFs. Results. A total of f 5540 ASCVD patients were enrolled. Mean age was 57.5 ± 11.6 years, and 1333 (24.1%) were women. Of the whole group, 214 (3.9%) were SMuRF-less, 3014 (54.4%) had 1-2 SMuRFs and 2312 (41.7%) had 3-4 SMuRFs. Compared with the SMuRFs groups, SMuRF-less group were younger, more likely to be men, and had lower prevalence of obesity, physical inactivity, metabolic syndrome, heart failure and chronic kidney disease. SMuRF-less patients were less likely to receive secondary prevention cardiovascular medications (antiplatelet agents, statins, renin angiotensin blockers and beta blockers); all p < 0.001. One year survival in the SMuRF-less patients was significantly lower than that in the SMuRFs groups (97.7% vs.98.4% vs.98.3%, respectively, p = 0.01). Multivariate analysis showed that young age, absence of heart failure and utilization of secondary preventive medications were associated with better one year outcome.
Conclusion: In this cohort of ME patients with ASCVD, nearly four in 100 were SMuRF-less. This rate is lower than that reported by most of published studies, mainly due to the high prevalence of the 4 SMuRFs. SMuRF-less patients were younger, had less comorbid disease, received less secondary prevention pharmacotherapy and had higher rate of one year mortality than those with SMuRFs.
Clinical trials: The study is registered with ClinicalTrials.gov, unique identifier number NCT06199869.
期刊介绍：
An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.
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