Objective To study AMI effect of early plasma renin on the long-term prognosis of AMI patients after optimized treatment. Methods Fifty-eight patients with acute myocardial infarction were hospitalized in the Department of Cardiology of the Affiliated Hospital of Chengde Medical University from October 2018 to October 2019. The general clinical data and laboratory examination indexes of the patients were recorded, and the plasma renin concentration after lying flat for 6 hours was measured for 1 week The left ventricular end diastolic anteroposterior diameter (LVEDD) and left ventricular ejection fraction(LVEF) were measured by echocardiography. LVEDD, LVEF The values of the 6-minute walk test(6MWT) and follow-up recorded major adverse cardiovascular events(MACE) was divided into high renin group and low renin group according to the plasma renin concentration. The differences of LVEDD, LVEF, 6MWT and mace between the two groups after 1 year were compared, and the differences of LVEDd and LVEF during hospitalization and 1 year after discharge were compared. Results After 1 year of follow-up, there was no significant difference in LVEDd, LVEF, 6MWT and mace between the high renin group and the low renin group(P>0.05). One year after discharge, LVEF was significantly higher than that during hospitalization (P<0.001). Conclusion The early plasma renin in patients with AMI after optimized treatment has no effect on the 1-year prognosis, and the cardiac function of patients with acute myocardial infarction can be improved after optimized treatment for 1 year.