Background & Objective: Cardiovascular disease is a major global health problem. Countries with low to moderate income contribute significantly to the global burden of cardiovascular disease accounting for 78% of all deaths and 86.3% of all disabilities. This study was an attempt to determine the factors contributing to premature myocardial infarction among young adults in Ardabil city.

 Methods: In this Case-control study 52 subjects, under 45, with myocardial infarction, admitted to Buali hospital in 2003-2004, were compared with 52 age and sex matched population based controls. Odds ratio and confidence interval of 95% were used to evaluate the risk factors such as smoking, physical activity, family history, history of diabetes and similar factors. Analysis of variance was used to compare the means.

 Results: The mean age of the subjects was 37.2 and 96.2% of them were male. The positive family history of cardiovascular disease with odds ratio of 9.4 (95% CI=2.6-34.3) and current smoking with odds ratio of 2.8 (95% CI=1.3-6.2) associated with myocardial infarction. Mean of the body mass index and mean of concentration of FBS, LDL and HDL were different in case and control groups. Physical activity with odds ratio of 0.4 had protective effect. (95% CI= 0.2-0.8). There was no meaningful relationship between passive smoking, total cholesterol, education and job with myocardial infarction risk.

 Conclusion: Family history, smoking, high Fasting Blood Sugar, high LDL, Low HDL and physical inactivity are the most important factors associated with acute myocardial infarction. Proper health interventions should be considered in order to lower the risk factors among young adults especially those under 45 years of age with a positive family history of myocardial infarction.