PMID- 36936250
OWN - NLM
STAT- MEDLINE
DCOM- 20230321
LR  - 20230328
IS  - 2211-8179 (Electronic)
IS  - 2211-8160 (Print)
IS  - 2211-8160 (Linking)
VI  - 18
IP  - 1
DP  - 2023
TI  - Outcomes of ST Segment Elevation Myocardial Infarction without Standard 
      Modifiable Cardiovascular Risk Factors - Newer Insights from a Prospective 
      Registry in India.
PG  - 13
LID - 10.5334/gh.1189 [doi]
LID - 13
AB  - OBJECTIVES: Patients with ST elevation myocardial infarction (STEMI) without 
      standard modifiable cardiovascular risk factors (SMuRFs; dyslipidaemia, 
      hypertension, diabetes mellitus and smoking) are reported to have a worse 
      clinical outcome compared to those with SMuRFs. However, robust prospective data 
      and low-and middle-income country perspective are lacking. We aimed to study the 
      patients with first STEMI and assess the influence of SMuRFs on clinical outcomes 
      by comparing the patients with and without SMuRFs. METHODS: We included all 
      consecutive STEMI patients without prior coronary artery disease enrolled in the 
      Madras Medical College STEMI Registry from September 2018 to October 2019. We 
      collected baseline clinical characteristics, revascularisation strategies and 
      clinical outcome. We analysed suboptimal self-reported sleep duration as a 5(th) 
      extended SMuRF (eSMuRF). Primary outcome was in-hospital mortality. Secondary 
      outcomes included in-hospital complications and one-year all-cause mortality. 
      RESULTS: Among 2,379 patients, 605 patients (25.4%) were SMuRF-less. More women 
      were SMuRF-less than men (27.1% vs 22.1%; P = 0.012). SMuRF-less patients were 
      older (57.44 +/- 13.95 vs 55.68 +/- 11.74; P < 0.001), more often former tobacco 
      users (10.4% vs 5.0%; P < 0.001), with more anterior wall MI (62.6% vs 52.1%; P = 
      0.032). The primary outcome [in-hospital mortality (10.7% vs 11.3%; P = 0.72)] 
      and secondary outcomes [in-hospital complications (29.1% vs 31.7%; P = 0.23) and 
      one-year all-cause mortality (22.3% vs 22.7%; P = 0.85)] were similar in both 
      groups. Addition of suboptimal self-reported sleep duration as a 5(th) eSMuRF 
      yielded similar results. CONCLUSIONS: 25% of first STEMI patients were 
      SMuRF-less. Clinical outcomes of patients without SMuRFs were similar to those 
      with SMuRFs. Suboptimal sleep duration did not account for the risk associated 
      with the SMuRF-less status.
CI  - Copyright: (c) 2023 The Author(s).
FAU - Justin Paul, Gnanaraj
AU  - Justin Paul G
AUID- ORCID: 0000-0002-8588-5594
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Sankaran, Sabarish
AU  - Sankaran S
AUID- ORCID: 0009-0004-3333-9120
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Saminathan, Karthikaa
AU  - Saminathan K
AUID- ORCID: 0009-0007-4184-3230
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Iliyas, Mohamed
AU  - Iliyas M
AUID- ORCID: 0000-0001-9585-4209
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Sethupathy, Suryakanth
AU  - Sethupathy S
AUID- ORCID: 0009-0009-2913-5383
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Saravanan, Sivasubramaniam
AU  - Saravanan S
AUID- ORCID: 0009-0000-6706-9967
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Prabhu, Salai Sudhan
AU  - Prabhu SS
AUID- ORCID: 0000-0001-5265-4083
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Kurian, Sijoy
AU  - Kurian S
AUID- ORCID: 0009-0004-0354-9880
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Srinivas, Sandeep
AU  - Srinivas S
AUID- ORCID: 0009-0009-9593-9072
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Anurag, Polavarappu
AU  - Anurag P
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Srinivasan, Kumaran
AU  - Srinivasan K
AUID- ORCID: 0009-0008-3223-9207
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Manimegalai, Elavarasi
AU  - Manimegalai E
AUID- ORCID: 0009-0004-8722-4839
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Nagarajan, Swaminathan
AU  - Nagarajan S
AUID- ORCID: 0009-0001-7797-2110
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Ramesh, Rajasekar
AU  - Ramesh R
AUID- ORCID: 0009-0008-1541-6291
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Nageswaran, P M
AU  - Nageswaran PM
AUID- ORCID: 0000-0001-6579-5308
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Sangareddi, Venkatesan
AU  - Sangareddi V
AUID- ORCID: 0000-0002-1176-8192
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
FAU - Govindarajulu, Ravishankar
AU  - Govindarajulu R
AUID- ORCID: 0000-0003-4815-8117
AD  - Institute of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India.
AD  - Rajiv Gandhi Government General Hospital, Park Town, Chennai, India.
AD  - The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, India.
LA  - eng
PT  - Journal Article
DEP - 20230316
PL  - England
TA  - Glob Heart
JT  - Global heart
JID - 101584391
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - *ST Elevation Myocardial Infarction/epidemiology
MH  - Risk Factors
MH  - *Cardiovascular Diseases/etiology
MH  - India/epidemiology
MH  - Heart Disease Risk Factors
MH  - Registries
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Hospital Mortality
MH  - Treatment Outcome
PMC - PMC10022543
OTO - NOTNLM
OT  - Myocardial infarction
OT  - atherosclerosis
OT  - mortality
OT  - outcome
OT  - risk factors
COIS- The authors have no competing interests to declare.
EDAT- 2023/03/21 06:00
MHDA- 2023/03/22 06:00
PMCR- 2023/03/16
CRDT- 2023/03/20 03:42
PHST- 2022/10/07 00:00 [received]
PHST- 2023/02/02 00:00 [accepted]
PHST- 2023/03/20 03:42 [entrez]
PHST- 2023/03/21 06:00 [pubmed]
PHST- 2023/03/22 06:00 [medline]
PHST- 2023/03/16 00:00 [pmc-release]
AID - 10.5334/gh.1189 [doi]
PST - epublish
SO  - Glob Heart. 2023 Mar 16;18(1):13. doi: 10.5334/gh.1189. eCollection 2023.