Heart disease strikes healthy patients harder, new guidelines aim to save lives
Researchers have identified a troubling pattern: patients who suffer heart attacks despite having no conventional risk factors face unexpectedly high early death rates. A new clinical pathway aims to catch what doctors missed, potentially improving outcomes for millions considered "low-risk" who actually aren't.
Originaltitel: Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors: <em>JACC</em> State-of-the-Art Review
<p>Reducing the incidence and prevalence of standard modifiable cardiovascular risk factors (SMuRFs) is critical to tackling the global burden of coronary artery disease (CAD). However, a substantial number of individuals develop coronary atherosclerosis despite no SMuRFs. SMuRFless patients presenting with myocardial infarction have been observed to have an unexpected higher early mortality compared to their counterparts with at least 1 SMuRF. Evidence for optimal management of these patients is lacking. We assembled an international, multidisciplinary team to develop an evidence-based clinical pathway for SMuRFless CAD patients. A modified Delphi method was applied. The resulting pathway confirms underlying atherosclerosis and true SMuRFless status, ensures evidence-based secondary prevention, and considers additional tests and interventions for less typical contributors. This dedicated pathway for a previously overlooked CAD population, with an accompanying registry, aims to improve outcomes through enhanced adherence to evidence-based secondary prevention and additional diagnosis of modifiable risk factors observed. (c) 2023 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).</p>