Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction

• DOI: 10.1161/01.cir.99.6.779
• Publication Date: 2012-06-12T00:42:29Z
• Authors: Michel de Lorgeril; Patricia Salen; Jean-Louis Martin; Isabelle Monjaud; Jacques Delaye; Nicole Mamelle
• Keywords: Stroke; Unstable angina

Background —The Lyon Diet Heart Study is a randomized secondary prevention trial aimed at testing whether Mediterranean-type diet may reduce the rate of recurrence after first myocardial infarction. An intermediate analysis showed striking protective effect 27 months follow-up. This report presents results an extended follow-up (with mean 46 per patient) and deals with relationships dietary patterns traditional risk factors recurrence. Methods Results —Three composite outcomes (COs) combining either cardiac death nonfatal infarction (CO 1), or preceding plus major end points (unstable angina, stroke, heart failure, pulmonary peripheral embolism) 2), minor events requiring hospital admission 3) were studied. In Mediterranean group, CO 1 was reduced (14 versus 44 in prudent Western-type P =0.0001), as 2 (27 90, =0.0001) 3 (95 180, =0.0002). Adjusted ratios ranged from 0.28 to 0.53. Among factors, total cholesterol (1 mmol/L being associated increased 18% 28%), systolic blood pressure mm Hg 1% 2%), leukocyte count (adjusted ranging 1.64 2.86 >9×10 9 /L), female sex ratios, 0.27 0.46), aspirin use 0.59 0.82) each significantly independently Conclusions pattern maintained up 4 years infarction, confirming previous analyses. Major such high pressure, shown be independent joint predictors recurrence, indicating that did not alter, least qualitatively, usual between Thus, comprehensive strategy decrease cardiovascular morbidity mortality should include primarily cardioprotective diet. It other (pharmacological?) means reducing modifiable factors. Further trials approaches are warranted.