Prevalence and Outcomes in STEMI Patients Without Standard Modifiable Cardiovascular Risk Factors: A National Inpatient Sample Analysis

To evaluate the in-hospital mortality and acute STEMI-related complications in a SMuRF-less STEMI population compared with a SMuRF STEMI population in the United States. The National Inpatient Sample (NIS) Database (2005-2014) was analyzed to identify patients with STEMI using ICD-9. Patients were grouped into SMuRF and SMuRF-less based on the presence of ≥1 SMuRF risk factor. The primary outcomes were the prevalence and in-hospital mortality of SMuRF-less patients. Secondary outcomes were rates of in-hospital complications in STEMI patients. A total of 434,111 STEMI patients were identified with 318,281 (73.4%) and 115,830 (26.6%) patients in the SMuRF and SMuRF-less categories, respectively. In multivariable logistic regression analysis, SMuRF-less patients had a higher in-hospital mortality rate (odds ratio [OR]: 1.670; 95% confidence interval [CI]: 1.620-1.722) and acute renal failure (OR: 1.724; 95% CI: 1.662-1.787). SMuRF-less STEMI patients have higher odds of in-hospital mortality and in-hospital STEMI-related complications compared with SMuRF STEMI patients.