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Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease
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 associate...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929377/ https://www.ncbi.nlm.nih.gov/pubmed/27109584 http://dx.doi.org/10.1093/eurheartj/ehw125 |
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author | Stewart, Ralph A. H. Wallentin, Lars Benatar, Jocelyne Danchin, Nicolas Hagström, Emil Held, Claes Husted, Steen Lonn, Eva Stebbins, Amanda Chiswell, Karen Vedin, Ola Watson, David White, Harvey D. |
author_facet | Stewart, Ralph A. H. Wallentin, Lars Benatar, Jocelyne Danchin, Nicolas Hagström, Emil Held, Claes Husted, Steen Lonn, Eva Stebbins, Amanda Chiswell, Karen Vedin, Ola Watson, David White, Harvey D. |
author_sort | Stewart, Ralph A. H. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4929377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-49293772016-07-05 Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease Stewart, Ralph A. H. Wallentin, Lars Benatar, Jocelyne Danchin, Nicolas Hagström, Emil Held, Claes Husted, Steen Lonn, Eva Stebbins, Amanda Chiswell, Karen Vedin, Ola Watson, David White, Harvey D. Eur Heart J Clinical Research 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. Oxford University Press 2016-07-01 2016-04-24 /pmc/articles/PMC4929377/ /pubmed/27109584 http://dx.doi.org/10.1093/eurheartj/ehw125 Text en © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Research Stewart, Ralph A. H. Wallentin, Lars Benatar, Jocelyne Danchin, Nicolas Hagström, Emil Held, Claes Husted, Steen Lonn, Eva Stebbins, Amanda Chiswell, Karen Vedin, Ola Watson, David White, Harvey D. Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title | Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title_full | Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title_fullStr | Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title_full_unstemmed | Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title_short | Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
title_sort | dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929377/ https://www.ncbi.nlm.nih.gov/pubmed/27109584 http://dx.doi.org/10.1093/eurheartj/ehw125 |
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