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目的:探讨有或无心血管风险因素的急性心肌梗死患者临床特点及预后状况，为临床治疗提供参考依据。方法:对2015年11月至2018年12月在国家卫生健康委员会登记的22 780例(取部分有效信息)急性心肌梗死患者进行分析。排除3 432例患者后，根据是否存在心血管风险因素将患者分为两组，其中无心血管风险因素为对照组(2 840例)，有心血管风险因素为观察组(16 508例)，观察两组间临床特点、心功能指标、并发症及预后情况。结果:两组间年龄、症状、血压、心率、入院时血糖、入院时肌酐、总胆固醇、甘油三酸酯、HDL-C、LDL-C组间差异有统计学意义(n P<0.05)。两组间冠脉造影检查结果，单支病变、左主干或多支血管、左前降枝、左旋支、右冠状动脉、左主干道组间差异有统计学意义(n P<0.05)。观察组与对照组在院期间死亡率(2.6% vs 3.1%，n P＝0.450)和并发症(20.6% vs 20.0%，n P＝0.647)差异无统计学意义。1年后临床结果显示，对照组的全因死亡率为2.0%(57/2 840)，观察组为1.3%(21/16 508)，差异有统计学意义(n P＝0.031)。n 结论:即使在无心血管风险因素影响下老年患者也易发生急性心肌梗死。因此，对于无任何心血管危险因素的患者仍需给予全方面的监护。“,”Objective:To investigate the clinical features and prognosis of acute myocardial infarction with or without cardiovascular risk factors.Methods:22 780 patients with acute myocardial infarction registered with the National Health Commission from November 2015 to December 2018 were analyzed. After excluding 3 432 patients, the patients were divided into two groups according to whether there were cardiovascular risk factors. The control group (2 840 cases) had no cardiovascular risk factors, and the observation group (16 508 cases) had cardiovascular risk factors. The clinical characteristics, cardiac function indexes, complications and prognosis were observed between the two groups.Results:There were significant differences in age, symptoms, blood pressure, heart rate, blood glucose, creatinine, total cholesterol, triglyceride, high density lipid-cholesterol (HDL-C) and low density lipid-cholesterol (LDL-C) between the two groups (n P<0.05). The results of coronary angiography showed that there were significant differences in single vessel disease, left main or multiple vessels, left anterior descending branch, left circumflex branch, right coronary artery and left main artery between the two groups (n P<0.05). There was no difference in mortality (2.6% vs 3.1%,n P=0.450) and complications (20.6% vs 20.0%, n P=0.647) between the observation group and the control group. One year later, the clinical results showed that the all-cause mortality of the control group was 2.0% (57/2 840) and that of the observation group was 1.3% (215/16 508), with statistically significant difference (n P=0.031).n Conclusions:Even without cardiovascular risk factors, elderly patients are prone to acute myocardial infarction. Therefore, patients without any cardiovascular risk factors still need to be given full monitoring.