Most risk factors for premature MI modifiable

Premature myocardial infarction (MI) is associated with risk factors—such as dyslipidaemia and obesity, among others—that can be modified with interventions, according to the results of a systematic review and meta-analysis.

Researchers accessed online databases for observational studies evaluating the association of at least one risk factor (demographic characteristics, lifestyle factors, clinical risk factors, or biomarkers) with premature MI (which occurred in men aged 18-55 years and women aged 18-65 years).

The search yielded 35,320 articles involving 12.7 million participants. Of these, the researchers identified 19 risk factors from 77 studies across 58 countries.

Compared with women, men had about a twofold greater likelihood of developing premature MI (odds ratio [OR], 2.39, 95 percent confidence interval [CI], 1.71–3.35). The risk of premature MI was especially high in the presence of a family history of cardiac disease (OR, 2.67, 95 percent CI, 2.29–3.27).

Other factors associated with premature MI were modifiable. These included current smoking (OR, 4.34, 95 percent CI, 3.68–5.12), diabetes mellitus (OR, 3.54, 95 percent CI, 2.69–4.65), dyslipidaemia (OR, 2.94, 95 percent CI, 1.76–4.91), hypertension (OR, 2.85, 95 percent CI, 2.48–3.27), and higher body mass index (≥25 vs <25 kg/m²: OR, 1.46, 95 percent CI, 1.24–1.71).

Biomarkers such as total cholesterol levels >200 mg/dL, triglyceride levels >150 mg/dL, and high-density lipoprotein cholesterol levels <60 mg/dL conferred about two- to threefold risk increase.

The findings highlight the need to develop interventions at the person, population, and policy levels to reduce the burden of the said risk factors and of premature MI.