Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors

Figtree, Gemma A. and Vernon, Stephen T. and Harmer, Jason A. and Gray, Michael P. and Arnott, Clare and Bachour, Eric and Barsha, Giannie and Brieger, David and Brown, Alex and Celermajer, David S. and Channon, Keith M. and Chew, Nicholas W.S. and Chong, James J.H. and Chow, Clara K. and Cistulli, Peter A. and Ellinor, Patrick T. and Grieve, Stuart M. and Guzik, Tomasz J. and Hagström, Emil and Jenkins, Alicia and Jennings, Garry and Keech, Anthony C. and Kott, Katharine A. and Kritharides, Leonard and Mamas, Mamas A. and Mehran, Roxana and Meikle, Peter J. and Natarajan, Pradeep and Negishi, Kazuaki and O’Sullivan, John and Patel, Sanjay and Psaltis, Peter J. and Redfern, Julie and Steg, Philippe G. and Sullivan, David R. and Sundström, Johan and Vogel, Birgit and Wilson, Andrew and Wong, Dennis and Bhatt, Deepak L. and Kovacic, Jason C. and Nicholls, Stephen J. and Ademi, Zanfina and Avis, Suzanne Robyn and Chan, Adam and Contreras, Osvaldo and Coorey, Craig P. and Fathieh, Sina and Genetzakis, Elijah and Gholipour, Alireza and Giles, Corey and Hollings, Matthew and Hyun, Karice and Kazi, Samia and Kovacic, Jason C. and Larance, Mark and Marathe, Jessica A. and Marquina, Clara and Nelson, Adam and Ng, Hooi Hooi and Patrick, Ellis and Peter, Karlheinz and Tran, Andy and Yang, Jean and Zhu, Dantong and Zwack, Clara (2023) Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors. Journal of the American College of Cardiology, 82 (13). pp.1343-1359. ISSN 07351097

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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.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Depositing User: Repository Administrator
Date Deposited: 01 May 2024 04:30
Last Modified: 01 May 2024 04:30

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