How to Identify Those Most at Risk.

Researchers have been studying the puzzling trend of the high frequency of heart attacks among people who do not have commonly known modifiable risks for cardiovascular disease, including smoking, high blood pressure, high cholesterol, and diabetes. For heart attacks that come from blocked arteries (ST-elevation heart attacks), it is one in four patients. In heart attacks where oxygen is still getting to the heart but not enough (non-ST-elevation heart attacks), it is one in five patients.

In a study, researchers at Intermountain Healthcare, Salt Lake City, Utah, examined non-ST-elevation heart attack patients and found that those without known modifiable risk factors fared better than those with them.

These findings are important because they add to a body of research that may lead to ways to identify who and why these patients are at risk of having heart attacks, and design better care methods to prevent them.

"The best time to treat a heart attack is before you have one, and we need to figure out how we can help these kinds of patients before they do," says cardiologist Jeffrey L. Anderson.

In the retrospective study, researchers identified 8,196 patients who had a non-ST-elevation myocardial infarction (NSTEMI), the most common type of heart attack, where the...