Abstract: AIM:To investigate the long-term prognosis and the related factors in patients with acute myocardial infarction (AMI). METHODS: Clinical data of 4 887 cases diagnosed as AMI between January 2003 and December 2013 in our three hospitals in Hubei Province were analyzed. Medical records, initial laboratory test results, medication compliance after discharge and clinical outcomes were collected. According to different clinical outcomes, patients were divided into good outcome group and poor outcome group. Single and multiple factor logistic regression analyses were performed to explore the risk factors that may affect the long-term prognosis. RESULTS: Among the 4 887 AMI cases, 3 829 cases had good outcomes and 1 058 had poor outcomes, including 116 deaths, 32 recurrent myocardial infractions and 910 heart failures. Gender, weight, heart rate, systolic blood pressure, diastolic blood pressure, left ventricular diameter, cTnT, BNP, Glu-2h, LDL-C, and cholesterol in the poor outcome group were significantly higher than those in the good outcome group (P>0.05). Incidence rates of hypertension, diabetes mellitus, COPD, atrial fibrillation and therioma in the poor outcome group were higher than those in the good outcome group (70.5% vs. 38.9, P<0.05; 59.9% vs. 33.4%, P<0.05; 19.5% vs. 4.9%, P<0.05; 1.1% vs. 0.3%, P<0.05). Multivariate logistic regression analysis revealed that left ventricular diameter (OR=3.10, P<0.01, CI 2.83-186.44) and LDL-C (OR=2.90, P<0.01, CI 2.08-156.87) were the risk factors affecting the long-term prognosis of AMI. CONCLUSION: Enlarged left ventricular diameter and LDL-C are the risk factors affecting the long-term prognosis in patients with acute myocardial infarction.