PMID- 35990971
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220823
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - Cardiovascular magnetic resonance characteristics and clinical outcomes of 
      patients with ST-elevation myocardial infarction and no standard modifiable risk 
      factors-A DANAMI-3 substudy.
PG  - 945815
LID - 10.3389/fcvm.2022.945815 [doi]
LID - 945815
AB  - INTRODUCTION: A higher 30-day mortality has been observed in patients with 
      first-presentation ST elevation myocardial infarction (STEMI) who have no 
      standard modifiable cardiovascular risk factors (SMuRFs), i. e., diabetes, 
      hypertension, hyperlipidemia, and current smoker. In this study, we evaluate the 
      clinical outcomes and CMR imaging characteristics of patients with and without 
      SMuRFs who presented with first-presentation STEMI. METHODS: Patients from the 
      Third DANish Study of Acute Treatment of Patients With ST-Segment Elevation 
      Myocardial Infarction (DANAMI-3) with first-presentation STEMI were classified 
      into those with no SMuRFs vs. those with at least one SMuRF. RESULTS: We 
      identified 2,046 patients; 283 (14%) SMuRFless and 1,763 (86%) had >0 SMuRF. 
      SMuRFless patients were older (66 vs. 61 years, p < 0.001) with more males (84 
      vs. 74%, p < 0.001), more likely to have left anterior descending artery (LAD) as 
      the culprit artery (50 vs. 42%, p = 0.009), and poor pre-PCI (percutaneous 
      coronary intervention) TIMI (thrombolysis in myocardial infarction) flow </=1 (78 
      vs. 64%; p < 0.001). There was no difference in all-cause mortality, non-fatal 
      reinfarction, or hospitalization for heart failure at 30 days or at long-term 
      follow-up. CMR imaging was performed on 726 patients. SMuRFless patients had 
      larger acute infarct size (17 vs. 13%, p = 0.04) and a smaller myocardial salvage 
      index (42 vs. 50%, p = 0.02). These differences were attenuated when the higher 
      LAD predominance and/or TIMI 0-1 flow were included in the model. CONCLUSION: 
      Despite no difference in 30-day mortality, SMuRFless patients had a larger 
      infarct size and a smaller myocardial salvage index following first-presentation 
      STEMI. This association was mediated by a larger proportion of LAD culprits and 
      poor TIMI flow pre-PCI. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov, unique 
      identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER) and NCT01960933 
      (DANAMI 3-PRIMULTI).
CI  - Copyright (c) 2022 Mazhar, Ekstrom, Kozor, Grieve, Nepper-Christensen, Ahtarovski, 
      Kelbaek, Hofsten, Kober, Vejlstrup, Vernon, Engstrom, Lonborg and Figtree.
FAU - Mazhar, Jawad
AU  - Mazhar J
AD  - Kolling Research Institute, University of Sydney, Sydney, NSW, Australia.
FAU - Ekstrom, Kathrine
AU  - Ekstrom K
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Kozor, Rebecca
AU  - Kozor R
AD  - Kolling Research Institute, University of Sydney, Sydney, NSW, Australia.
FAU - Grieve, Stuart M
AU  - Grieve SM
AD  - Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles 
      Perkins Centre, University of Sydney, Sydney, NSW, Australia.
AD  - Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW, 
      Australia.
FAU - Nepper-Christensen, Lars
AU  - Nepper-Christensen L
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Ahtarovski, Kiril A
AU  - Ahtarovski KA
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Kelbaek, Henning
AU  - Kelbaek H
AD  - Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
FAU - Hofsten, Dan E
AU  - Hofsten DE
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Kober, Lars
AU  - Kober L
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Vejlstrup, Niels
AU  - Vejlstrup N
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Vernon, Stephen T
AU  - Vernon ST
AD  - Kolling Research Institute, University of Sydney, Sydney, NSW, Australia.
FAU - Engstrom, Thomas
AU  - Engstrom T
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
AD  - Department of Cardiology, Lund University Hospital, Lund, Sweden.
FAU - Lonborg, Jacob
AU  - Lonborg J
AD  - Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University 
      Hospital, Copenhagen, Denmark.
FAU - Figtree, Gemma A
AU  - Figtree GA
AD  - Kolling Research Institute, University of Sydney, Sydney, NSW, Australia.
LA  - eng
SI  - ClinicalTrials.gov/NCT01960933
SI  - ClinicalTrials.gov/NCT01435408
PT  - Journal Article
DEP - 20220803
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9383416
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - atherosclerosis
OT  - cardiovascular magnetic resonance
OT  - cardiovascular risk factors
OT  - coronary artery disease
COIS- Author LK reports Speakers honorarium from Novo, Novartis, AstraZeneca and 
      Bohringer, unrelated to this manuscript. TE reports personal fees from Abbott, 
      Bayer, and AstraZeneca outside the submitted work. GF reports personal consulting 
      fees from CSL and grants from Abbott Diagnostic outside the submitted work. The 
      remaining authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/23 06:00
MHDA- 2022/08/23 06:01
PMCR- 2022/01/01
CRDT- 2022/08/22 04:04
PHST- 2022/05/17 00:00 [received]
PHST- 2022/06/30 00:00 [accepted]
PHST- 2022/08/22 04:04 [entrez]
PHST- 2022/08/23 06:00 [pubmed]
PHST- 2022/08/23 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.945815 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2022 Aug 3;9:945815. doi: 10.3389/fcvm.2022.945815. 
      eCollection 2022.