Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry.

Autor:	Roger G; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France., Ducrocq G; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France., Mesnier J; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France., Sayah N; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France., Abtan J; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France., Ferrari R; Centro Cardiologico Universitario di Ferrara, University of Ferrara, Ferrara, Italy.; Scientific Department of Medical Trial Analysis (MTA), Lugano, Switzerland., Ford I; Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK., Fox KM; National Heart and Lung Institute, Imperial College, London, UK., Tardif JC; Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada., Tendera M; Department of Cardiology and Structural Heart Disease, Medical University of Silesia, Katowice, Poland., Feldman LJ; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France., Elbez Y; Signifience Statistics, Paris, France., Steg PG; Cardiology Department, AP-HP, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France.; Université Paris-Cité, INSERM U1148, FACT (French Alliance for Cardiovascular Trials), 46 Rue Henri Huchard, 75018 Paris, France.; Institut Universitaire de France, 1 rue Descartes, 75231 Paris, France.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2024 Jul 12; Vol. 45 (27), pp. 2396-2406.
DOI:	10.1093/eurheartj/ehae299
Abstrakt:	Background and Aims: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs-diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods: CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE-CV death, non-fatal MI, or non-fatal stroke). Results: Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08-7.19] vs. 7.68% [95% CI 7.30-8.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions: SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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