Risk Factors for Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Abstract

Objective: To comprehensively analyze the risk factors of acute myocardial infarction (AMI), clarify the association strength of emerging risk factors and gender differences, and provide evidence-based basis for the primary prevention of AMI. Methods: Following the PRISMA (Page et al., 2021) guidelines, In addition, hand searching of the reference lists of identified papers. An electronic search of CNKI, WanFang database, VIP, CBM, PubMed, The Cochrane Library, Web of Science, and Embase databases was performed from inception until June 2024. Results: One hundred and twenty-five studies were identified as suitable for inclusion in the analysis, of which 78 were case-control studies and 47 were cohort studies. In the meta-analysis results, 18 risk factors affecting the occurrence of AMI were identified, which are smoking, insufficient sleep time, or sleep time ≥ 9 h, hypertension, diabetes, dyslipidemia, family of coronary heart disease, BMI ≥ 24 kg/m², waist circumference, waist-hip ratio, fibrinogen, uric acid, C-reactive protein, homocysteine, lipoprotein a, periodontal disease, depression, Helicobacter pylori infection, and migraine. Meanwhile, the analysis revealed gender differences in the effects of smoking, hypertension, diabetes, migraine, and AMI. Conclusion: The analysis showed a stronger association of these factors with AMI in women than in men. However, the reliability of this gender difference remains to be established. Intervening in these modifiable risk factors can significantly reduce the occurrence of AMI.

Keywords

Acute myocardial infarction / Risk factors / Review / Meta-analysis

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