Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease.

Abstract

OBJECTIVES:

To determine whether dietary pattern assessed by a simple self-administered food frequency questionnaire is associated with major adverse cardiovascular events (MACE) in high-risk patients with stable coronary artery disease.

BACKGROUND:

A Mediterranean dietary pattern has been associated with lower cardiovascular (CV) mortality. It is less certain whether foods common in western diets are associated with CV risk.

METHODS:

At baseline, 15 482 (97.8%) patients (mean age 67 ± 9 years) with stable coronary heart disease from 39 countries who participated in the Stabilisation of atherosclerotic plaque by initiation of darapladib therapy (STABILITY) trial completed a life style questionnaire which included questions on common foods. A Mediterranean diet score (MDS) was calculated for increasing consumption of whole grains, fruits, vegetables, legumes, fish, and alcohol, and for less meat, and a 'Western diet score' (WDS) for increasing consumption of refined grains, sweets and deserts, sugared drinks, and deep fried foods. A multi-variable Cox proportional hazards models assessed associations between MDS or WDS and MACE, defined as CV death, non-fatal myocardial infarction, or non-fatal stroke.

RESULTS:

After a median follow-up of 3.7 years MACE occurred in 7.3% of 2885 subjects with an MDS ≥15, 10.5% of 4018 subjects with an MDS of 13-14, and 10.8% of 8579 subjects with an MDS ≤12. A one unit increase in MDS >12 was associated with lower MACE after adjusting for all covariates (+1 category HR 0.95, 95% CI 0.91, 0.98, P = 0.002). There was no association between WDS (adjusted model +1 category HR 0.99, 95% CI 0.97, 1.01) and MACE.

CONCLUSION:

Greater consumption of healthy foods may be more important for secondary prevention of coronary artery disease than avoidance of less healthy foods typical of Western diets.

• Authors: Ralph A H Stewart, Lars Wallentin, Jocelyne Benatar, Nicolas Danchin, Emil Hagström, Claes Held, Steen Husted, Eva Lonn, Amanda Stebbins, Karen Chiswell, Ola Vedin, David Watson, Harvey D White, STABILITY Investigators
• Journal: European heart journal (Eur Heart J) Vol. 37 Issue 25 Pg. 1993-2001 (Jul 01 2016) ISSN: 1522-9645 [Electronic] England
• PMID: 27109584 (Publication Type: Journal Article)
• Copyright: © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

Topics

• Aged
• Coronary Disease
• Diet, Mediterranean
• Humans
• Myocardial Infarction
• Proportional Hazards Models
• Risk Factors