Number of standard modifiable risk factors and mortality in patients with first-presentation ST-segment elevation myocardial infarction: insights from China Acute Myocardial Infarction registry

• DOI: 10.1186/s12916-022-02418-w
• Publication Date: 2022-07-05T23:02:19Z
• Authors: Sidong Li; Xiaojin Gao; Jingang Yang; Haiyan Xu; Yang Wang; Yanyan Zhao; Lu Yin; Chao Wu; Yi Wang; Yang Zheng; Bao Li; Xuan Zhang; Yunqing Ye; Rui Fu; Qiuting Dong; Hui Sun; Xinxin Yan; Yuan Wu; Jun Zhang; Chen Jin; Wei Li; Yuejin Yang
• Keywords: Male; China; R; Myocardial Infarction; ST-elevation myocardial infarction; Risk Factors; Modifiable risk factors; Medicine; Humans; ST Elevation Myocardial Infarction; Female; Registries; Mortality; Research Article

Abstract Background Recent publications reported a paradoxical finding that there was an inverse association between the number of standard modifiable risk factors (SMuRFs; smoking, hypertension, diabetes, and hyperlipidemia) mortality in patients with myocardial infarction. However, current evidence is only limited to those highly developed countries advanced medical management systems. Methods The China Acute Myocardial Infarction registry prospective observational study including acute infarction from three-level hospitals across 31 administrative regions throughout mainland China. A total 16,228 first-presentation ST-elevation (STEMI) admitted January 2013 September 2014 were enrolled analysis. Cox proportional hazard models adjusting for baseline characteristics, clinical profiles at presentation, in-hospital treatments used assess SMuRFs all-cause 30 days after STEMI presentation. Results 1918 (11.8%), 11,503 (70.9%), 2807 (17.3%) had 0, 1–2, 3–4 respectively. Patients fewer older more likely be females, experienced longer pre-hospital delays, less receive primary percutaneous coronary intervention evidence-based medications. Compared without any SMuRF, 1–2 associated HR 0.74 (95% CI, 0.63–0.87) 0.63 (0.51–0.77) up unadjusted model ( P trend < 0.0001). multivariate adjustment, positively increased (HR SMuRFs, 1.15 [0.95–1.39]; 1.31 [1.02–1.68]; = 0.03), significant among beyond 12 h onset 1.39 [1.03–1.87]; 2.06 [1.41–3.01]) but not their counterparts interaction 0.01). Conclusions crude explained by confounding related poor (old age, management). After higher risk-factor burden prognosis STEMI.