Abstract | BACKGROUND: OBJECTIVE: DESIGN: We included 4146 state-of-the-art drug-treated patients aged 60-80 y with a history of myocardial infarction (79% male patients) and reliable dietary data at baseline (2002-2006). Cause-specific mortality was monitored until 1 January 2013. HRs for CVD mortality and IHD mortality for theoretical, isocaloric replacement of dietary fatty acids (FAs) in quintiles (1-5) and continuously (per 5% of energy) were obtained from Cox regression models, adjusting for demographic factors, medication use, and lifestyle and dietary factors. RESULTS: Patients consumed, on average, 17.5% of energy of total UFAs, 13.0% of energy of SFAs, and <1% of energy of TFAs. During ∼7 y of follow-up, 372 CVD deaths and 249 IHD deaths occurred. Substitution modeling yielded significantly lower risks of CVD mortality when replacing SFAs plus TFAs with total UFAs [HR in quintile 5 compared with quintile 1: 0.45 (95% CI: 0.28, 0.72)] or PUFAs [HR: 0.66 (95% CI: 0.44, 0.98)], whereas HRs in cis MUFA quintiles were nonsignificant. HRs were similar for IHD mortality. In continuous analyses, replacement of SFAs plus TFAs with total UFAs, PUFAs, or cis MUFAs (per 5% of energy) was associated with significantly lower risks of CVD mortality (HRs between 0.68 and 0.75) and IHD mortality (HRs between 0.55 and 0.70). CONCLUSION: Shifting the FA composition of the diet toward a higher proportion of UFAs may lower CVD mortality risk in drug-treated patients with cardiac disease. This study was registered at clinicaltrials.gov as NCT03192410.
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Authors | Famke J M Mölenberg, Janette de Goede, Anne J Wanders, Peter L Zock, Daan Kromhout, Johanna M Geleijnse |
Journal | The American journal of clinical nutrition
(Am J Clin Nutr)
Vol. 106
Issue 3
Pg. 895-901
(Sep 01 2017)
ISSN: 1938-3207 [Electronic] United States |
PMID | 28793994
(Publication Type: Journal Article)
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Copyright | © 2017 American Society for Nutrition |
Chemical References |
- Dietary Fats
- Fatty Acids, Unsaturated
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Topics |
- Aged
- Aged, 80 and over
- Cardiovascular Diseases
(mortality, prevention & control)
- Cohort Studies
- Dietary Fats
(administration & dosage)
- Fatty Acids, Unsaturated
(administration & dosage)
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(complications)
- Myocardial Ischemia
(mortality, prevention & control)
- Proportional Hazards Models
- Prospective Studies
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