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Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry
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Abstract
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.
Oxford University Press (OUP)
Guillaume Roger
Grégory Ducrocq
Jules Mesnier
Neila Sayah
Jérémie Abtan
Roberto Ferrari
Ian Ford
Kim M Fox
Jean-Claude Tardif
Michal Tendera
Laurent J Feldman
Yedid Elbez
Philippe Gabriel Steg
P G Steg
R Ferrari
I Ford
K M Fox
J C Tardif
M Tendera
Fernando José Sokn
Christopher Reid
Irene Lang
Frank Van den Branden
Luis Machado César
Nazar Luqman
Assen Goudev
Paul Dorian
Dayi Hu
Petr Widimsky
Christian Hassager
Nicolas Danchin
Stefan Kääb
Panos Vardas
Kadhim J 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 Erglis
Aleksandras Laucevičius
Ahmad Nizar Jamaluddin
Marco Alcocer Gamba
Igor I Tulevski
Janina Stępińska
Jońo Morais
Cezar Macarie
Rafael Oganov
Svetlana Shalnova
Muayed Al-Zaibag
Mak Koon Hou
Assoc Gabriel Kamensky
Zlatko Fras
Vojko Kanič
Datshana Prakesh Naidoo
José Luis Zamorano
Hans Rickli
Andres Jaussi
Assoc Charn Sriratanasathavorn
Paul Kalra
Mykhailo Lutai
Oleksandr Parkhomenko
Lan Viet Nguyen
Ronald Henry
A Ahuad Guerrero
M Basara
F Belcastro
J A Bertarini
C Cazenave
H Dreycopp
J Egido
J Estrella
D Garofalo
J Giordano
H Lagioia
N Lago
R La Greca
L Lema
N Lopez Cabanillas
H Luquez
C Miller
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P Rodenas
R G Schena
G Suarez
A Tomatti
D M Colquhoun
A Conradie
S Cox
D Cross
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B Fitzgerald
I Hamilton-Craig
G Holt
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L A Elizondo Sifuentes
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E Marín Araez
F Marín Ortuño
A Martín Santana
J Martínez Florez
J Martínez González
J F Martínez Rivero
D Marzal Martín
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A Melero Pita
E Molina Laborda
G Miñana Escrivá
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M A Montero Gaspar
J Mora Robles
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C Moya López
N Murga Eizagaechevarría
F Narro García
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C Navas Navas
E Novo García
J A Núñez Gamero
A Ordóñez España
J A Ortiz de Murua López
E Orts Soler
E Otero Chulian
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A J Paule Sánchez
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V Pedrosa del Moral
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M J Pinilla Lozano
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E Prieto Moriche
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M Rayo Gutiérrez
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J Rodríguez Collado
A Rodríguez Fernández
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I Rodríguez Tejero
I Romeo Castillejo
D Romero Alvira
J A Romero Hinojosa
C Romero Menor
P Rossi Sevillano
E C Rueda Calle
J Rueda Soriano
P Ruiz Pérez
T Sagastagoitia Gorostiza
I Sainz Hidalgo
M Sandin Rollán
S Santaolalla Rodríguez
E Santas Olmeda
J L Santos Iglesias
M L Sanz Rodríguez
I Segura Laborda
S Serrano García
B Sevilla Toral
L Silva Melchor
E Simarro Martín-Ambrioso
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C Soriano Navarro
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P Talavera Calle
E Teijeira Fernández
P L Torres Díaz
A Troncoso Gil
F Trujillo Berraquero
M A Ulecia Martínez
J Umaran Sánchez
C Vaticón Herreros
A Vázquez García
J L Vega Barbado
E Velasco Espejo-Saavedra
T Vicente Vera
M Vida Gutiérrez
C Villar Mariscal
G Vives Boniato
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G Yanes Bowden
J C Yañez Wonenburger
J L Zamorano Gómez
J Zarauza Navarro
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A Jaussi
A Forclaz
M Grobéty
L Schlueter
C Vuille
C A Nacht
D Evéquoz
S Ciaroni
F Dominé
J Bérubé
H Rickli
J Hellermann
R Koller
G Bourgeois
R Engel
C Niederberger
P Stadler
M Gnädinger
C Schmied
T Wettstein
P Hilti
C A Chételat
F Sepulcri
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M Kraus
V Vivekaphirat
S Panpunnung
S Kuanprasert
W Wongcharoen
A Phrommintikul
J Harinasuta
O Si
V Chaithiraphan
T Boonyasirinant
W Boonyapisit
M Kittipovanonth
A Buakhamsri
D Piyayotai
P Hutayanon
S Junejo
O Aiyegbayo
H Ancliff
C Bradshaw
R Cervenak
H Choi
E George
I Gilmour
D Gough
A Idrissi
J Ingham
B Al
A Liston
J Mackrell
I Pattison
R Ramachandran
N Ray
G Reddy
I Sen
K Shetty
L Singh
M Stanley
A Wallace
M Weatherhead
T Gilbert
G McCansh
S Higgins
C Killeen
I Cromarty
P Franklin
E Pinch
A Dhesi
C Dernedde
M Lawrence
H Simper
M Noble
G Dalton
L Stevens
P Berry
C Hand
R Oliver
H Jones
P Sampson
N Taylor
R Grogono
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A Martin
S Thurston
K Elsby
M Vallis
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C Lang
A Watson
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H Dougall
B La Hay
L Compson
A McCracken
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F Weber
D Richmond
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H MacCowan
A Heap
M Perry
L A Holden
G Scott
N Haldane
S Hood
I Cullen
J Bell
P McNaught
M Sharif
J Dunn
D Hay
S Ross
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R Burns
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A Kennedy
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M Brown
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D Troup
A Woodall
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A Yusuf
I Benett
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H Thomas
I Caldwell
P Ormiston
S Kwok
S Wright
N Kanumilli
P Saul
H Milligan
I Wilkinson
A Vance
N Paul
C Paul
I Shaikh
R Ellis
N Vites
R Steeds
D Goodwin
A Aftab
S Banham
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M S Grocutt
A Gupte
R Jordan
B S Jheeta
K Ladha
M Nazir
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R P Patel
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A B Syed
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I Illushechkin
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I Sadykova
O Zalyzniak
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M H Pham
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K B Do
T B LE
P A Do
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Q H Do
K C Vu
N H Pham
T H T Pham
M C Ta
D P Phan
T T H Nguyen
T T N Pham
T L To
V T Le
L Dang
L Bui
T T H Pham
H H Phan
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K A Ngo
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T T L ONG
V B Doan
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V D Tran
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A C Tran
M H Ngo
N H Vu
I T Ly
N P H Tran
L U P Tran
T N Nguyen
T H Tran
P H Truong
T L Mai
V S Hoang
C M A Bui
V P Dang
Q B Truong
M P Vo
V T Nguyen
N H Chau
T T H Ta
H N Dinh
H Tran
H K N Nguyen
A Chung
E Chung
B Martina
R Angela
P Ramoutar
R Fillet
R Tilluckdharry
T Dookie
E Foster
C Hart
F Omardeen
S Ramphall
C Lalla
R Henry
J Cheng
V Elliott
H Falconer
L Hurlock
R Ishmael
G Lalljie
K Lee
A Liqui
R Massay
H Mohammed
C Brown
R Daniel
M Didier
Title: Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry
Description:
Abstract
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.
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e0543 Clinical and coronary angiography characteristics between young (<45) and old (>60) patients with coronary artery disease
e0543 Clinical and coronary angiography characteristics between young (<45) and old (>60) patients with coronary artery disease
Objective
To study the clinical Clinical and coronary angiography characteristics between young (≤45) and old (>60) patients with coronary artery disease.
...
e0425 Clinical and coronary angiography characteristics between young (≤45) and old (>60) patients with coronary artery disease
e0425 Clinical and coronary angiography characteristics between young (≤45) and old (>60) patients with coronary artery disease
Objective
To study the clinical Clinical and coronary angiography characteristics between young (≤45) and old (>60) patients with coronary artery disease.
...
Are Cervical Ribs Indicators of Childhood Cancer? A Narrative Review
Are Cervical Ribs Indicators of Childhood Cancer? A Narrative Review
Abstract
A cervical rib (CR), also known as a supernumerary or extra rib, is an additional rib that forms above the first rib, resulting from the overgrowth of the transverse proce...
Beyond Coronary Risk: Clinical Scores as Predictors of Atrial Fibrillation in Chronic Coronary Syndrome
Beyond Coronary Risk: Clinical Scores as Predictors of Atrial Fibrillation in Chronic Coronary Syndrome
Atrial fibrillation frequently coexists with chronic coronary syndrome, sharing common cardiovascular risk factors and pathophysiological mechanisms. Identifying patients with chro...
Ischemia-Guided Coronary Revascularization Following Lower-Extremity Revascularization Improves 5-Year Survival of Patients With Chronic Limb-Threatening Ischemia
Ischemia-Guided Coronary Revascularization Following Lower-Extremity Revascularization Improves 5-Year Survival of Patients With Chronic Limb-Threatening Ischemia
Purpose:
To determine whether diagnosis of asymptomatic (silent) coronary ischemia using coronary computed tomography (CT)-derived fracti...
Extravasal compression of distal coronary arteries in immobilizing interstitial fibrosis of the heart – Shevchenko-Brado angiographic symptom complex
Extravasal compression of distal coronary arteries in immobilizing interstitial fibrosis of the heart – Shevchenko-Brado angiographic symptom complex
Heart failure is usually based on damage to cardiomyocytes. At the same time, the most common cause of myocardial dysfunction is coronary heart disease (CHD), various inflammatory ...
A study on risk factors of coronary artery disease in Chong Qing city
A study on risk factors of coronary artery disease in Chong Qing city
Objective
To investigate the relationship between risk factors and coronary artery disease in Chong Qing city, and to provide scientific basis for preventing and ...

