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This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE\u2014CV death, non-fatal MI, or non-fatal stroke).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08\u20137.19] vs. 7.68% [95% CI 7.30\u20138.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehae299","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T23:35:32Z","timestamp":1715384132000},"page":"2396-2406","source":"Crossref","is-referenced-by-count":14,"title":["Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8310-7919","authenticated-orcid":false,"given":"Guillaume","family":"Roger","sequence":"first","affiliation":[{"name":"Cardiology Department, AP-HP, H\u00f4pital Bichat , 46 Rue Henri Huchard, 75018 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9gory","family":"Ducrocq","sequence":"additional","affiliation":[{"name":"Cardiology Department, AP-HP, H\u00f4pital Bichat , 46 Rue Henri Huchard, 75018 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