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

作者：Guillaume Roger, Grégory Ducrocq, Jules Mesnier, Neila Sayah, Jérémie Abtan, Roberto Ferrari, Ian Ford, Kim Fox, Jean‐Claude Tardif, Michał Tendera, Laurent J. Feldman, Yedid Elbez, Philippe Gabríel Steg, CLARIFY Investigators, Philippe Gabríel Steg, Roberto Ferrari, Ian Ford, Kim Fox, Jean‐Claude Tardif, Michał Tendera, Fernando Sökn, Christopher M. Reid, Iréne Lang, F. Van Den Branden, Luis Machado César, Nazar Luqman, Assen Goudev, Paul Dorian, Dayi Hu, Petr Widimský, Christian Hassager, Nicolas Danchin, Stefan Kääb, Panos Vardas, Kadhim Sulaiman, Wael Al Mahmeed, Jassim Al Suwaidi, Ibrahim Al Rashdan, Fuad Abdulkader, Béla Merkely, Upendra Kaul, Kieran Daly, Luigi Tavazzi, Roberto Ferrari, Yangsoo Jang, Andrejs Ērglis, Aleksandras Laucevičius, Ahmad Nizar Jamaluddin, Marco Alcocer Gamba, Igor I. Tulevski, Janina Stępińska, Jońo Morais, Cezar Macarie, Р. Г. Оганов, S. А. Shalnova, Muayed Al‐Zaibag, Mak Koon Hou, Assoc Gabriel Kamensky, Zlatko Fras, Vojko Kanič, D.P. Naidoo, José Luis Zamorano, Hans Rickli, Andres Jaussi, Assoc Charn Sriratanasathavorn, Paul R. Kalra, Mykhailo Lutai, Oleksandr Parkhomenko, Lan Viet Nguyen, Ronald M.A. Henry, Andrea A. Guerrero, Michael L. Basara, Fernando Belcastro, J A Bertarini, C Cazenave, H Dreycopp, J. Egido, Jeannelyn S. Estrella, Diana C. Garofalo, Jennifer Giordano, H Lagioia, Nieves Martínez Lago, R La Greca, Leonor Varela Lema, Néstor López-Cabanillas, Hugo A Luquez, Chad Miller, Elena Prada, Paloma Albacete Ródenas, R G Schena, G Suárez, Alejandro Tomatti, David Colquhoun, A. Conradie, Shanice Cox, Deanna Cross, Robert Fathi, B. Fitzgerald, Ian Hamilton‐Craig, Geoff Holt, Sakunthala Jayasinghe, N Mai, Johan A. Moolman, R. Motyer, Katherine W. Phillips, Anthony Rafter, A. Rahman, A. Rainbird, G. Scalia, Addison A. Taylor, Patrick West, Kevin Alford, R. Amor, P Astridge, Boris C. Bastian, Frank S. Bates, M. Doohan, J Du Plooy, Janet Ford, Lukshe Kanagaratnam, Vincent Khoury, Rebecca Parkin, Jennifer K. Rogers, G Sceats, Amy Waldman, D Wang, Sally Wright, JES Ardill, Philip E. Aylward, John F. Beltrame, Julie A. Bradley, William Heddle, Matthew Joseph, S. Rajendran, S Varughese, Edmund Brice, Bernard E.F. Hockings, Judith Janssen, Antoni Kozłowski, Joyce E O’Shea, Jonathan T. Tan, David Playford, Keith V Woollard, A. Ajani, Gemma A. Barron, Nathan Better, Thomas N. Carruthers, B. Chan, Ruth Chan, Joseph V. Cotroneo, J. Counsell, D. Eccleston, Brett H Forge, A. J. Hamer, Mark Horrigan, V. Michael Jelinek, Raymond Lew, D O'Donnell, Fabio Panetta, Martin Sebastian, Prakash Shetty, Alan Soward, Piyush Srivastava, N. Strathmore, S. Sylivris, G. Szto, V Veth, Terence Yip, R Badr-Eslam, Lucas Kleemann, Günther Steurer, B Mörz-Proszowski, F Auhser, U Teleky, G Sepp, A dreas Beinhauer, Darko Kero, C Lavicka, Teodora Perger, V Hadjiivanov, M Feldner-Busztin, R Mika, Wioleta Filip, Alfred Mahr, J Toplak, M G Millauer, P Haralambus, K Walcher, K H Karner, E Ziak, P Painsipp, Ulrich Frank, ANTON SUNTINGER, Walter Gritsch, G. Bode, Rolf Herrmann, R Raffelsberger, Hg Topf, E. C. Moser, J Föchterle, T Honsig, Karl Mayr, Harald Mayr, R Kaserbacher, Alexander Dzien, E Galehr, M Felbermayer, R Schwarz, Rose‐Marie Amini, H Appeltants, A Ballet, Clémence Niel, Guy Berkenboom, Xavier Bernard, T. Bouvy, Mathias Claeys, Y. Dascotte, Laurent Davin, T De Backer, A. De Meester, S. de Ridder, Paul Dendale, K Denef, Marieke Emonts, J T M Geraedts, Marc Goethals, J.M. Grégoire, T Herbots, E Hoffer, W. Hutse, Patrick R. LaFontaine, Philippe Lefèbvre, H Lesseliers, G Odent, A. 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Ishmael, G R Lalljie, K Lee, A Liqui, Ryan Massay, Hossam Albeyoumi Mohammed, Christopher Brown, R Daniel, Morgane Didier · 发表于：European Heart Journal · 年份：2024 · DOI：10.1093/eurheartj/ehae299 · 被引用次数：8 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Acute Myocardial Infarction Research、Lipoproteins and Cardiovascular Health

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. CONCLUSI...