High dietary inflammatory index is associated with decreased plaque stability in patients with coronary heart disease

Area of Science:

• Cardiovascular Medicine
• Nutritional Science
• Pathology

Background:

• Coronary heart disease (CHD) plaque stability is crucial, with inflammation playing a key role.
• The Dietary Inflammatory Index (DII) quantifies diet's inflammatory potential based on 21 nutrients.
• Previous research suggests a link between diet and cardiovascular health, but specific associations with plaque stability require further investigation.

Purpose of the Study:

• To investigate the association between the Dietary Inflammatory Index (DII) and coronary plaque stability in patients with CHD.
• To determine if a pro-inflammatory diet, as indicated by a high DII, correlates with indicators of unstable plaques.

Main Methods:

• Cross-sectional study involving 314 CHD patients.
• Dietary Inflammatory Index (DII) calculated from food frequency questionnaires.
• Coronary plaque stability assessed using optical coherence tomography (OCT) to identify characteristics like thin-cap fibroatheroma, macrophage infiltration, and plaque rupture.

Main Results:

• Higher DII scores were significantly associated with unstable plaque characteristics: thin-capped fibroatheroma (OR, 3.60), macrophage infiltration (OR, 2.16), and plaque rupture (OR, 3.55) after adjusting for confounders.
• Mediation analysis indicated DII mediates the relationship between plaque stability and intake of specific foods like soybeans, nuts, fish, shrimp, and eggs.
• The DII ranged from -1.41 to 3.04 in the study population.

Conclusions:

• Elevated DII is significantly associated with decreased coronary plaque stability in CHD patients.
• These findings highlight the potential protective role of anti-inflammatory diets in managing coronary heart disease.
• Dietary modification, guided by DII, may represent a novel therapeutic strategy for CHD prevention and management.