Department of Medicine (Cardiology), NYU School of Medicine, New York, New York.
Department of Medicine (Cardiology), NYU School of Medicine, New York, New York; Department of Medicine (Cardiology), San Francisco Veterans Affairs Medical Center and University of California San Francisco, California, California.
Am J Cardiol. 2019 Mar 15;123(6):865-873. doi: 10.1016/j.amjcard.2018.11.056. Epub 2018 Dec 18.
Poor dietary patterns are associated with coronary artery disease (CAD) and cardiovascular events. The aim of this study was to determine whether reported dietary patterns change after undergoing invasive coronary angiography. Participants without a history of coronary revascularization were prospectively enrolled before undergoing coronary angiography at a tertiary center between February 2015 and February 2017. Enrolled participants completed the Rate Your Plate (RYP) survey at baseline (before angiography), 1-month, and 6-month follow-ups. RYP scores range from 24 to 72 (higher scores indicate healthier dietary patterns) are presented as median (interquartile range), and are compared from baseline to follow-up using a nonparametric related-sample test. No dietary guidance was given outside of usual care. Of the 400 participants, 326 (82%) completed at least 1 follow-up survey with no differences in baseline characteristics of participants who had at least 1 versus no follow-up survey. The median RYP score significantly improved from baseline (53 [47 to 57]) to 1-month (58 [52 to 62]) and 6-month (59 [54 to 63]) follow-ups (p <0.001). Angiography demonstrated severe CAD in 125 (38%) and normal or nonobstructive CAD in 201 (62%) participants. RYP scores significantly improved over time in both groups (p <0.001), but the percent change in RYP score over time was greater in participants with versus without severe CAD (13.9% [5.8 to 22.5] vs 9.6% [4.8 to 19.1], p = 0.03). In conclusion, self-reported dietary patterns improved after invasive coronary angiography, particularly in the subset with CAD. Future studies to determine how best to utilize the periprocedural period to further improve dietary patterns in this population are warranted.
不良的饮食模式与冠状动脉疾病 (CAD) 和心血管事件有关。本研究旨在确定在接受介入性冠状动脉造影后,报告的饮食模式是否发生变化。在 2015 年 2 月至 2017 年 2 月期间,于一家三级中心在接受冠状动脉造影之前,前瞻性招募了没有冠状动脉血运重建史的参与者。入组的参与者在基线(造影前)、1 个月和 6 个月随访时完成了饮食频率问卷(Rate Your Plate,RYP)调查。RYP 评分范围为 24 到 72 分(得分越高表示饮食模式越健康),以中位数(四分位间距)表示,并使用非参数相关样本检验比较从基线到随访的变化。除了常规护理之外,没有提供任何饮食指导。在 400 名参与者中,326 名(82%)至少完成了 1 次随访调查,且至少有 1 次随访调查的参与者与无随访调查的参与者在基线特征方面无差异。RYP 评分从基线(53 [47 到 57])显著改善到 1 个月(58 [52 到 62])和 6 个月(59 [54 到 63])随访(p <0.001)。血管造影显示 125 名(38%)参与者有严重 CAD,201 名(62%)参与者有正常或非阻塞性 CAD。两组的 RYP 评分随时间均显著改善(p <0.001),但严重 CAD 患者的 RYP 评分随时间的变化百分比大于无严重 CAD 患者(13.9% [5.8 到 22.5] vs 9.6% [4.8 到 19.1],p=0.03)。总之,侵入性冠状动脉造影后,自我报告的饮食模式有所改善,尤其是在 CAD 患者亚组中。未来的研究旨在确定如何最好地利用围手术期来进一步改善这一人群的饮食模式。