Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the Emergency Department?

Short answer, No. If a patient's symptoms waddle and quack like a heart attack, by golly, the cause of the symptoms might be a heart attack, even in the absence of cardiac risk factors.

Longer answer ... read the following:

Body R, McDowell G, Carley S and Mackway-Jones K. "Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the Emergency Department?" Resuscitation. 2009 May.

Han JH et al. The role of cardiac risk factor burden in diagnosing acute coronary syndromes in the emergency department setting. Ann Emerg Med 2007 Feb; 49:145-52.

or if short on time, help yourself to this short, but well written, briefing from Medscape.