Yamamoto K, Natsuaki M, Morimoto T, et al. - In patients receiving coronary revascularization, a higher crude incidence of all-cause death was observed in those without standard cardiovascular risk factors vs those with at least one risk factor. Post-adjustment for confounders, a significant mortality risk was noted in patients with chronic coronary syndrome (CCS) but not in patients with ST-segment elevation myocardial infarction (STEMI) and non–ST-segment elevation acute coronary syndrome (NSTE-ACS).

• A recent observational study revealed increased mortality in relation to STEMI without standard cardiovascular risk factors vs patients with risk factors.

• This study included 30,098 consecutive patients undergoing first coronary revascularization in the CREDO-Kyoto PCI/CABG registry cohort-2 and 3 (STEMI n = 8,312, NSTE-ACS n = 3,386, and CCS n = 18,400).

• Advanced age, low body weight, and malignancy were more frequent and history of atherosclerotic disease and prescription of optimal medical therapy were less frequent in patients without risk factors vs those with risk factors.

• STEMI patients without risk factors were more often women and more often experienced atrial fibrillation, long door-to-balloon time, and severe hemodynamic compromise.