OBJECTIVES: There is a trend of premature myocardial infarction (AMI) in the Chinese population. However, the impact of traditional risk factors, including diabetes, hyperlipidemia, hypertension, and smoking on premature acute myocardial infraction in China are not well known. To assess the relationship between traditional risk factors and premature AMI and death from premature AMI with China Acute Myocardial Infarction registry

METHODS: Between January 2013 and September 2014, 21,676 Chinese patients with first acute myocardial infraction from three-level hospitals across 31 administrative regions throughout mainland China were enrolled. And assessed their life expectancy free of acute coronary syndrome and mortality within 30 days and 2 years after hospital admission from acute coronary syndrome as estimated in relation to traditional risk factors (current smoking, hypertension, diabetes and hypercholesterolemia) stratified according to sex with inverse probability weighting analyses.

RESULTS: Compared with patients without any baseline traditional risk factors, the presence of all four risk factors was associated with a 7-year shorter life expectancy free of acute myocardial infraction in men (from 64.0 ± 13.0 to 56.6± 10.2 years; r = −0.137; P< 0.001) and 2.0 year in women (from 68.2 ± 12.5 to 66.2± 9.5 years; r = −0.023; P=0.0925). Premature acute myocardial infraction (women <65 years and men <55 years) was remarkably related to current smoking and hypercholesterolemia among men (RRs: 2.09; 95% CI: 1.95–2.25 and 1.50; 95% CI: 1.40–1.61, respectively) and women (RRs: 1.23; 95% CI: 1.02–1.49 and 1.34; 95% CI: 1.19–1.49, respectively). Diabetes was most strongly associated 2-year mortality after hospital admission from premature AMI in women (RR: 2.19; 95% CI: 1.60–3.00), and was associated 30-day mortality in women only (RR: 1.49; 95% CI: 1.01–2.21).

CONCLUSIONS: The public health policy in China should highly emphasis on lifestyle behaviors associated with the four traditional risk factors to reduce the burden of premature acute myocardial infarction.