Department of Medicine, Faculty of Health Sciences, McMaster University, 1280 Main St W., Hamilton L8S 4K1, Canada.
Hamilton Health Sciences, Population Health Research Institute, 237 Barton St. East, Hamilton, ON L8L 2X2, Canada.
Eur J Prev Cardiol. 2023 Jun 1;30(8):709-718. doi: 10.1093/eurjpc/zwad062.
Patients with coronary artery disease (CAD) and patients with peripheral artery disease (PAD) are at risk for major adverse cardiovascular events (MACE) and major adverse limb events (MALE). There are limited data regarding dietary patterns and the risk of recurrent MACE and MALE in CAD and PAD patients. We aimed to identify dietary patterns associated with MACE and MALE in patients with CAD and/or PAD.
We analysed data collected from patients enrolled into the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial, in which diet was assessed by a short food frequency questionnaire (FFQ) at baseline. Two dietary pattern scores, the modified Alternate Healthy Eating Index (mAHEI) and Mediterranean Diet Score (mMDS), were calculated. We tested the association between mAHEI and mMDS and the incidence of MACE and/or MALE. The mean mAHEI score was 23.0 ± 7.7 (out of 70) overall and was similar comparing CAD and PAD patients. The incidence of MACE or MALE was 6.3% in the lowest diet quality quartile (as assessed by mAHEI) compared with 4.2% in the highest quartile over 30 months. In the fully adjusted model, the hazard ratio of a low diet quality (Quartile 1) compared with the highest (Quartile 4) for MACE or MALE was 1.27 (95% CI: 1.08-1.49; P = 0.004, Q1 vs. Q4). This excess hazard was primarily driven by higher MACE in both the CAD and PAD cohorts.
Poor diet quality as assessed by the mAHEI is independently associated with a higher risk of recurrent MACE and MALE in patients with chronic CAD and/or PAD.
患有冠状动脉疾病（CAD）和外周动脉疾病（PAD）的患者有发生主要不良心血管事件（MACE）和主要不良肢体事件（MALE）的风险。关于饮食模式与 CAD 和 PAD 患者复发性 MACE 和 MALE 风险之间的关系，数据有限。我们旨在确定与 CAD 和/或 PAD 患者的 MACE 和 MALE 相关的饮食模式。
我们分析了参加抗凝策略在心血管结局中的应用（COMPASS）试验的患者的数据，该试验在基线时通过简短的食物频率问卷（FFQ）评估饮食。计算了两种饮食模式评分，改良交替健康饮食指数（mAHEI）和地中海饮食评分（mMDS）。我们测试了 mAHEI 和 mMDS 与 MACE 和/或 MALE 发生率之间的关联。总体而言，mAHEI 的平均得分是 23.0±7.7（满分 70 分），CAD 和 PAD 患者的得分相似。在 30 个月的时间里，最低饮食质量四分位数（mAHEI 评估）的 MACE 或 MALE 发生率为 6.3%，而最高四分位数为 4.2%。在完全调整的模型中，低饮食质量（四分位数 1）与最高饮食质量（四分位数 4）相比，MACE 或 MALE 的风险比为 1.27（95%CI：1.08-1.49；P=0.004，Q1 比 Q4）。这种额外的风险主要是由于 CAD 和 PAD 两个队列中 MACE 发生率更高所致。
用 mAHEI 评估的饮食质量差与慢性 CAD 和/或 PAD 患者复发性 MACE 和 MALE 的风险增加独立相关。
