Introduction The impact of risk factors for acute myocardial infarctions (AMI) differs across populations. The aim of this study was to determine the impact of established risk factors for the occurrence of non-fatal AMI within a population based case control study of urban Sri Lankans.

Methods Cases were patients consecutively admitted to the cardiology and general medical wards of the National Hospital of Sri Lanka with a confirmed diagnosis of AMI and discharged alive. Age and sex matched community controls were recruited within 20–30 km distance from National Hospital of Sri Lanka using the electoral lists. Basic demographic information, smoking habits, physical activity and dietary patterns, anthropometric indices, fasting glucose and serum lipid measurements were done on all participants.

Results During the study period, 262 cases and 246 controls were recruited. Of the non-fatal acute myocardial infarct patients, 18% were female. Compared to males, females with non-fatal events were significantly older (58 years, SD 6.6). Mean age among cases and controls were similar (∼54 years). Cases were significantly more likely to have diabetes mellitus, a family history of AMI, abnormalities in lipid profile and report poor vegetable and fruit consumption (consumption was defined as “poor” if the individual did not usually consume some fruit/vegetable at least once on a given day). Physical activity patterns, education level and smoking habits were similar between cases and controls.

Conclusion Results indicate a high prevalence of modifiable risk factors among AMI patients. It is vital that the health system identify these patients early and provide them with optimal treatment.