Long-term outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention without standard modifiable cardiovascular risk factors: findings from the OPT-CAD cohort.

IF 8.3 1区医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2025-02-24 DOI:10.1186/s12916-025-03933-2

Zaixin Jiang, Haiwei Liu, Miaohan Qiu, Jing Li, Wei Zhao, Donghong Zhang, Daoshen Liu, Kun Na, Yi Li, Yaling Han

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Abstract

Background: Acute coronary syndrome (ACS) patients without standard modifiable cardiovascular risk factors (SMuRFs) have a higher risk of early mortality. However, little is known about their long-term outcomes, especially for patients undergoing percutaneous coronary intervention (PCI). This study aims to explore the long-term outcomes and identify independent factors associated with adverse clinical outcomes in patients with ACS undergoing PCI without SMuRFs.

Methods: This study used data from Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease (OPT-CAD) registry study. Clinical characteristics and outcomes of patients with and without SMuRFs were examined. The primary outcomes were major adverse cardia-cerebrovascular events (MACCE). The long-term (5 years) outcomes were compared between the without and with SMuRFs group in such cohort. An exploratory Cox proportional hazards regression was performed to identify the independent demographic and clinical predictors of the adverse clinical outcomes in the SMuRFs-absent cohort.

Results: Among 5688 patients with ACS undergoing PCI, 392 (6.9%) were in the absence of SMuRFs and 5296 (93.1%) were in the presence of SMuRFs. There were no significant differences in MACCE rates between the two cohorts (9.44% vs. 9.76%, log-rank P = 0.90). Cox proportional hazards regression indicated that age (HR, 1.06; 95% CI, 1.03-1.10; P = 0.001) and thrombus lesions (HR, 2.58; 95% CI, 1.24-5.40; P = 0.011) were independently associated with MACCE in the SMuRFs-absent cohort.

Conclusions: Among patients with ACS undergoing PCI, SMuRFs-absent patients had similar MACCE rates when compared with those with one or more SMuRFs at 5 years. This suggests that effective intervention strategies and updated risk assessment models are urgently needed in the SMuRFs-absent cohort.

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急性冠状动脉综合征患者经皮冠状动脉介入治疗无标准可改变心血管危险因素的长期预后：来自OPT-CAD队列的研究结果

背景：无标准可改变心血管危险因素（smurf）的急性冠脉综合征（ACS）患者早期死亡风险较高。然而，对其长期预后知之甚少，特别是对接受经皮冠状动脉介入治疗（PCI）的患者。本研究旨在探讨无smurf的ACS行PCI患者的长期结局，并确定与不良临床结局相关的独立因素。方法：本研究使用中国冠状动脉疾病患者最佳抗血小板治疗（OPT-CAD）登记研究的数据。检查了有和没有smurf的患者的临床特征和结果。主要结局为主要心脑血管不良事件（MACCE）。比较该队列中无smurf组和有smurf组的长期（5年）结果。进行探索性Cox比例风险回归，以确定smurfs缺失队列中不良临床结果的独立人口学和临床预测因素。结果：5688例行PCI的ACS患者中，392例（6.9%）无smurf， 5296例（93.1%）有smurf。两组间MACCE发生率无显著差异（9.44%对9.76%,log-rank P = 0.90）。Cox比例风险回归显示年龄(HR, 1.06；95% ci, 1.03-1.10；P = 0.001)和血栓病变(HR, 2.58；95% ci, 1.24-5.40；P = 0.011)在smurfs缺失队列中与MACCE独立相关。结论：在接受PCI治疗的ACS患者中，没有SMuRFs的患者与有一个或多个SMuRFs的患者相比，5年时的MACCE发生率相似。这表明，缺乏smurfs的人群迫切需要有效的干预策略和更新的风险评估模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.