Vernon ST, Coffey S, D'Souza M, et al. - Researchers determined the proportion as well as outcomes of SMuRF (standard modifiable cardiovascular risk factors: hypertension, diabetes mellitus, hypercholesterolemia, smoking)-less ST-segment–elevation myocardial infarction (STEMI) patients in this study utilizing 2 sequential large, multicenter registries, ie, the Australian GRACE (Global Registry of Acute Coronary Events) and CONCORDANCE (Cooperative National Registry of Acute Coronary Syndrome Care) registries, including 42 hospitals. Overall 3,081 patients with STEMI and without a prior history of cardiovascular disease were identified. A higher in-hospital mortality rate was observed in SMuRF-less individuals vs those with 1 or more SMuRFs. The 2 groups did not differ significantly clinically in terms of major adverse cardiovascular events at 6 months. Findings revealed the occurrence of a substantial and rising proportion of STEMI presentations, independently of SMuRFs. New prophylactic strategies may be facilitated by recognizing novel markers and mechanisms of disease beyond standard risk factors.