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

Area of Science:

• Cardiology
• Nutrition Science
• Preventive Medicine

Background:

• Mediterranean dietary patterns are linked to reduced cardiovascular mortality.
• The association between Western dietary patterns and cardiovascular risk is less clear.
• High-risk patients with stable coronary artery disease (CAD) require effective secondary prevention strategies.

Purpose of the Study:

• To investigate the association between dietary patterns, specifically Mediterranean (MDS) and Western (WDS) diet scores, and major adverse cardiovascular events (MACE).
• To assess the role of dietary habits in secondary prevention among patients with stable coronary artery disease.

Main Methods:

• Utilized data from 15,482 patients with stable coronary heart disease in the STABILITY trial.
• Calculated Mediterranean Diet Score (MDS) and Western Diet Score (WDS) based on a self-administered food frequency questionnaire.
• Employed multivariable Cox proportional hazards models to analyze the association between MDS, WDS, and MACE (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke).

Main Results:

• A higher MDS (≥15) was associated with a lower incidence of MACE compared to lower scores (MDS ≤12).
• Each one-unit increase in MDS above 12 was associated with a 5% reduction in MACE (HR 0.95, 95% CI 0.91-0.98, P=0.002).
• No significant association was found between the WDS and MACE (adjusted HR 0.99, 95% CI 0.97-1.01).

Conclusions:

• Greater consumption of healthy foods, as indicated by a higher Mediterranean Diet Score, is crucial for secondary prevention in patients with coronary artery disease.
• Focusing on increasing intake of healthy foods may be more beneficial than solely avoiding less healthy Western dietary components.
• Dietary patterns emphasizing whole grains, fruits, vegetables, legumes, fish, and moderate alcohol intake are associated with improved cardiovascular outcomes.