The Paradox of SMURF-less Outcomes and its Implication for Diabetes
Journal
European Heart Journal - Quality of Care and Clinical Outcomes
Date Issued
2026-01-28
Author(s)
Cenko, Edina
Manfrini, Olivia
Yoon, Jinsung
Bergami, Maria
Vasiljevic, Zorana
Mendieta, Guiomar
Zdravkovic, Marija
Miličić, Davor
Ottani, Filippo
Badimon, Lina
Bugiardini, Raffaele
DOI
10.1093/ehjqcco/qcag012
Abstract
Individuals without standardized modifiable risk factors (SMuRF), which implicitly include those with diabetes, have been paradoxically reported to experience higher mortality following acute coronary syndromes (ACS). We aim to clarify the independent impact of diabetes on 30-day mortality after ACS and explore how grouping it with other SMuRF might obscure its true effect.
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