Coronary disease & ACSCohort study

Mortality After ST-Segment–Elevated Myocardial Infarction Among Patients With and Without Standard Modifiable Cardiovascular Risk Factors in China

Circ Popul Health OutcomesPublished

  • nationwide, multicenter cohort study
  • national registry derived from electronic medical records of accredited chest pain centers

Authors' 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

Main finding

All-cause mortality · 30 days

Adjusted hazard ratio

1.22

95% CI 1.19–1.25

By group

SMuRF-less vs SMuRF
adjusted hazard ratio 1.22 (95% CI 1.19–1.25)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeSMuRF-lessSMuRFadjusted hazard ratio (95% CI)
All-cause mortality · 31 to 365 days · no significance after covariate adjustment3.8%3.2%1.00 (0.95–1.04)

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:10.1161/circoutcomes.125.012224

Summarised from the published abstract; every number is checked against it