@article{7134ad68ed4a44ed9dae5f7bb8dc7285,
title = "Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors: JACC State-of-the-Art Review",
abstract = "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.",
keywords = "atherosclerosis, cardiovascular risk, clinical pathway, coronary artery disease, primary prevention, secondary prevention",
author = "Figtree, {Gemma A.} and Vernon, {Stephen T.} and Harmer, {Jason A.} and Gray, {Michael P.} and Clare Arnott and Eric Bachour and Giannie Barsha and David Brieger and Alex Brown 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 Emil Hagstr{\"o}m and Alicia Jenkins and Garry Jennings and Keech, {Anthony C.} and Kott, {Katharine A.} and Leonard Kritharides and Mamas, {Mamas A.} and Roxana Mehran and Meikle, {Peter J.} and Pradeep Natarajan and Kazuaki Negishi and John O'Sullivan and Sanjay Patel and Psaltis, {Peter J.} and Julie Redfern and Steg, {Philippe G.} and Sullivan, {David R.} and Johan Sundstr{\"o}m and Birgit Vogel and Andrew Wilson and Dennis Wong and Bhatt, {Deepak L.} and Kovacic, {Jason C.} and Nicholls, {Stephen J.} and Zanfina Ademi and Avis, {Suzanne Robyn} and Adam Chan and Osvaldo Contreras and Coorey, {Craig P.} and Sina Fathieh and Elijah Genetzakis and Alireza Gholipour",
note = "Publisher Copyright: {\textcopyright} 2023 The Authors",
year = "2023",
month = sep,
day = "26",
doi = "10.1016/j.jacc.2023.06.045",
language = "English",
volume = "82",
pages = "1343--1359",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier Inc.",
number = "13",
}