Role of sub-clinical inflammation and defective cholesterol efflux in myocardial infarction patients without standard modifiable risk factors
Authors' conclusion
Sub-clinical inflammation and defective cholesterol efflux were associated with SMuRF-less status of STEMI patients and had prognostic impact. This highlights the need to explore new therapeutic strategies in this high-risk population.
Study context
- Population
- ST-segment elevation myocardial infarction (STEMI) patients with and without standard modifiable cardiovascular risk factors (SMuRF)patients included, 178 (11.1%) SMuRF-less
- Participants
- 1,604 participants
- Exposure
- Patients with and without SMuRF
- SMuRF-lessn = 178
- Outcome
- Serum cholesterol efflux capacity
- Follow-up
- Baseline
Methodological detailsmultivariable Cox regression analyses
- Multivariable Cox regression analyses
Main finding
As reported in the abstract
SMuRF-less
0.79
± 0.16
SMuRF
0.83
± 0.16
P < 0.001
Observational data: associations, not effects.
Further findings
Highest tertile of IL-1β · baseline
P = 0.002
Highest hs-CRP level tertile · baseline · trend
P = 0.077
Crude rates of mortality · 1 year · higher in SMuRF-less
P < 0.001
Determinants of 1-year all-cause mortality (multivariable Cox)
- High tertile of high-sensitivity C-reactive protein (hs-CRP), HR (1.28-2.63), P = 0.001
- 1.83
- High tertile of IL-1β, HR (1.06-2.24), P = 0.024
- 1.54
- SMuRF-less status, HR (1.05-2.38) P = 0.029
- 1.56
- Higher serum cholesterol efflux capacity, HR (0.09-0.87), P = 0.028 (protective)
- 0.27
- After multivariable adjustment with traditional prognostic risk factors
Original publication
Role of sub-clinical inflammation and defective cholesterol efflux in myocardial infarction patients without standard modifiable risk factors. Eur Heart J Acute Cardiovasc Care. Published 6 May 2025. doi:10.
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