Mortality After ST-Segment–Elevated Myocardial Infarction Among Patients With and Without Standard Modifiable Cardiovascular Risk Factors in China
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 1.22 95% CI 1.19–1.25Authors' conclusion
In this nationwide analysis, nearly one-quarter of ST-segment-elevation myocardial infarction cases were SMuRF-less. Compared with patients with SMuRF, the mortality excess in SMuRF-less patients was confined to the first 30 days, and mortality did not differ subsequently.
Study context
- Population
- Adults aged ≥18 years with ST-segment-elevation myocardial infarction admitted between January 1, 2017, and December 31, 2021, at accredited chest pain centers across ChinaST-segment-elevation myocardial infarction patients, 87,830 (23.1%) SMuRF-less
- Participants
- 379,811 adults
- Exposure
- SMuRF-less patients vs those with SMuRF
- SMuRF-lessn = 87,830
- Outcome
- All-cause mortality
- Follow-up
- 30 days
Methodological detailsnational registry derived from electronic medical records of accredited chest pain centers
- National registry derived from electronic medical records of accredited chest pain centers
Main finding
As reported in the abstract
Adjusted hazard ratio
1.22
95% CI 1.19–1.25
By group
SMuRF-lessvs SMuRF
adjusted hazard ratio 1.22 (95% CI 1.19–1.25)
Observational data: associations, not effects.
Further findings
| Outcome | SMuRF-less | SMuRF | Adjusted hazard ratio (95% CI) | |
|---|---|---|---|---|
| All-cause mortality · 31 to 365 daysNo significance after covariate adjustment | 3.8% | 3.2% | 1.00 (0.95–1.04) | |
| 0.512Adjusted hazard ratio (log scale) |
30-day mortality associated with SMuRF-less status, by subgroup
- Consistent across most subgroups but significantly more pronounced in men than in women
- P for interaction <0.001
Original publication
Mortality After ST-Segment–Elevated Myocardial Infarction Among Patients With and Without Standard Modifiable Cardiovascular Risk Factors in China. Circ Popul Health Outcomes. Published 12 January 2026. doi:10.
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