Study on secondary prevention and the impact of risk factor control on myocardial infarction events in young patients with coronary heart disease

The incidence of coronary heart disease (CHD) among young adults has been steadily increasing, yet the control of risk factors and their impact on myocardial infarction (MI) events remain to be further studied. This study aims to analyze the control of major risk factors and their effects on MI events in young CHD patients. This retrospective study included 1032 young CHD patients who were followed up between January 2020 and December 2023. Baseline and follow-up data were collected, including the control status of risk factors such as smoking, diabetes, hypertension, and low-density lipoprotein cholesterol (LDL-C), as well as the occurrence of MI events. Multivariate logistic regression analysis was used to explore the association between risk factors and MI events. The study found that after risk factor interventions, the smoking rate decreased significantly from 75.1% at baseline to 36.2% at the end of follow-up (P < .001). The proportion of patients achieving HbA1c < 7.0% increased from 81.0% to 84.5% (P = .039), and the LDL-C target achievement rate (<1.8 mmol/L) improved markedly from 13.6% to 34.1% (P < .001). Multivariate regression analysis indicated that persistent smoking (OR = 2.27, P = .019) and failure to meet LDL-C targets (OR = 1.91, P = .025) were independent risk factors for MI. Furthermore, the greater the number of risk factors controlled, the lower the risk of MI. Patients achieving control of ≥ 4 risk factors had a significantly lower incidence of MI compared to those achieving control of ≤ 1 factor (P < .001). The control of risk factors in young CHD patients is closely related to the occurrence of MI events. Comprehensive interventions targeting multiple risk factors can significantly reduce the risk of MI. This study underscores the importance of smoking cessation, lipid management, and diabetes control in the secondary prevention of MI in young CHD patients, providing evidence for the optimization of clinical intervention strategies.