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Approved Research

Association of the life pattern with the risk of myocardial infarction (MI) in people without standard modifiable cardiovascular risk factors (SMuRFs)

Principal Investigator: Dr Yanjun Song
Approved Research ID: 97155
Approval date: January 16th 2023

Lay summary

SMuRFs, which include hypertension, dyslipidemia, diabetes mellitus and smoking, are demonstrated to increase the risk of cardiovascular events with no doubts. However, it has been found that a non-negligible proportion of patients with MI combined no SMuRF (13-27%), and the risk of people with no SMuRF is increasing for each year (2004-2019: 11-27%). Therefore, people with no SMuRF, who were described as SMuRF-less status, attached great attentions, and potential reasons for this phenomenon are still not elucidated. Previous studies have demonstrated that unhealthy lifestyles such as unhealthy diet and bad sleep pattern are significantly associated with increased incidence of cardiovascular events. Therefore, it raises great interests that whether the unhealthy life pattern is a pivotal contributor to MI risk in people with SMuRF-less status, which still lacks of explorations. In this investigation, life pattern was evaluated from 7 dimensions: diet, alcohol, sleep pattern, environmental exposure, socioeconomic status and mental health, and the association of different healthy extent of the life pattern with the risk of MI will be investigated in people without SMuRFs. Besides, SMuRF-less people with healthy or unhealthy life pattern will be compared with people with SMuRFs in the risk of MI, further determine the concrete risk brought by unhealthy life patterns in SMuRF-less people. Finally, we will document that whether the unhealthy life pattern is a key point which will bring huge risk of MI and should be paid more attentions in SMuRF-less patients.

Scope extension:


1)           Why the incidence of MI increased rapidly with time going (2004-2019: 11-27%)?

2)           Why there were a large part of patients with MI (13-27%) presented with no SMuRFs (SMuRFs-less status)?


   To investigate the association of life pattern with the risk of acute myocardial infarction in participants who are free from coronary artery disease and combine no SMuRF through comparing with patients with SMuRFs, aiming to determine that the unhealthy life condition pattern is a potential contributor for the great MI risk in SMuRF-less patients.

    Life pattern is defined as a combination of lifestyle [diet, alochol, physical activity, sleep quliaty] and life conditions [environmental condition, psychological conditon, socioeconomic condition].


Do life patterns impact a lot in the risk of cardiometabolic diseases?


To investigate the associations between life patterns and the risk of cardiometabolic disease (including coronary heart disease, arrhythmias, heart failure, stroke, hypertension, and diabetes mellitus) among participants in the UK biobank. Life patterns include lifestyles [diet, alcohol, physical activity, sleep quality] and life conditions [environmental condition, psychological condition, socioeconomic condition].