Worse outcomes of ACS patients without versus with traditional cardiovascular risk factors

• Published in: Journal of cardiology 2022-04, Vol.79 (4), p.515-521
• Main Authors: Shiyovich, Arthur, Ovdat, Tal, Klempfner, Robert, Beigel, Roy, Halabi, Majdi, Shiran, Avinoam, Skalsky, Keren, Porter, Avital, Orvin, Katia, Kornowski, Ran, Eisen, Alon
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - epidemiology; Acute Coronary Syndrome - etiology; Acute Coronary Syndrome - therapy; Cardiovascular Diseases - complications; Cardiovascular Diseases - etiology; Female; Heart Disease Risk Factors; Humans; Male; Middle Aged; Outcomes; Percutaneous Coronary Intervention - adverse effects; Risk Factors; Temporal trends; Traditional cardiovascular risk factors; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2021.10.019

•Patients without risk factors comprise 5.7% of patients with acute coronary syndrome, but declined over time•Patients without risk factors were less likely to receive interventional and medical therapy•Worse short- and long-term outcomes were found in patients without cardiovascular risk factors•Management and outcomes of patients without cardiovascular risk factors improved over time Up to 20% of patients presenting with acute coronary syndrome (ACS) have no traditional cardiovascular risk-factors (RFs). Data regarding the determinants, management, and outcomes of these patients are scarce. To evaluate the management, outcomes, and time-dependent changes of ACS patients without RFs. Evaluation of clinical characteristics, management strategies, and outcomes as well as time-dependent changes [by 3 time periods: early (2000-2006), mid (2008-2013), and late (2016-2018)] of ACS patients without RFs (diabetes mellitus, hypertension, dyslipidemia, family history of ischemic heart disease, and smoking) or known coronary artery disease, enrolled in the biennial ACS Israeli Surveys (ACSIS) between 2000 and 2018. We compared ACS patients without RFs (no-RF group) to those with ≥1 RFs (RF group). Overall, 554/9,683 (5.7%) eligible ACS patients did not have any RFs [median age 63 (IQR 52-76) years, 25% females]. The no-RF group were older, with lower body mass index and prevalence of other cardiovascular comorbidity and chronic kidney disease compared with the RF group. The in-hospital percutaneous coronary intervention rates were lower among the no-RF vs. the RF group (55% vs. 66%, respectively p