Number of Coronary Heart Disease Risk Factors and Mortality in Patients With First Myocardial Infarction

REVIOUS STUDIES HAVE EXAM-2][3][4][5] These studies have included a meta-analysis from 14 international randomized clinical trials, 1 a case-control study, 2 results from 3 epidemiologic cohort studies, 3 a single-center academic institution, 4 and a community-based registry of patients with non-ST-segment elevation MI only. 5In all of these reports, a majority of patients with MI presented with at least 1 of the 4 major modifiable cardiac risk factors (hypertension, smoking, dyslipidemia, and diabetes).However, these studies were limited to specific populations (those selected for clinical trials, cohorts restricted to a certain geographical area [Chicago or Framingham, Massachusetts], or patients with non-ST-segment elevation MI).Most of these studies did not focus on inpatient mortality during hospitalization for first MI.However, a recent study from a quality improvement initiative reported a modest but surprising inverse association between number of CHD risk factors and mortality in patients with non-STsegment elevation MI only. 5e National Registry of Myocardial Infarction (NRMI) represents a large and generalizable communitybased cohort study of patients hospitalized with acute MI.The main objectives of our study were to ascertain the CHD risk factor distribution of pa-