Association between beta-carotene and acute myocardial infarction depends on polyunsaturated fatty acid status. The EURAMIC Study. European Study on Antioxidants, Myocardial Infarction, and Cancer of the Breast.
Because antioxidants may play a role in the prevention of coronary heart disease by inhibiting the peroxidation of polyunsaturated fatty acids (PUFAs), the combined association of diet-derived antioxidants and PUFAs with acute myocardial infarction (MI) was investigated. This multicenter case-control study included 674 patients and 725 control subjects in eight European countries and Israel. Fatty acid composition and alpha-tocopherol and beta-carotene levels were determined in adipose tissue; selenium level was determined in toenails. For alpha-tocopherol no association with MI was observed at any PUFA level. The overall multivariate odds ratio (OR) for low (10th percentile) versus high (90th percentile) beta-carotene was 1.98 (95% confidence interval [CI], 1.39 to 2.82). The strength of this inverse association with MI was dependent on PUFA levels (in tertiles): for low PUFA, the OR for low versus high beta-carotene was 1.79 (95% CI, 0.98 to 3.25), for medium PUFA the OR was 1.76 (95% CI, 1.00 to 3.11), and for high PUFA 3.47 (95% CI, 1.93 to 6.24). For selenium increased risk was observed only at the lowest PUFA tertile (OR, 2.49; 95% CI, 1.22 to 5.09). This interaction between selenium and PUFAs was not significant and may at least partly be explained by a higher proportion of smokers at the low PUFA level. These findings support the hypothesis that beta-carotene plays a role in the protection of PUFAs against oxidation and subsequently in the protection against MI. No evidence was found that alpha-tocopherol or selenium may protect against MI at any level of PUFA intake.
Kardinaal
A F
AF
Department of Epidemiology, TNO Nutrition and Food Research, Zeist, Netherlands.
Aro
A
A
Kark
J D
JD
Riemersma
R A
RA
van 't Veer
P
P
Gomez-Aracena
J
J
Kohlmeier
L
L
Ringstad
J
J
Martin
B C
BC
Mazaev
V P
VP
D000273:Adipose Tissue / Q000378:metabolism; D000975:Antioxidants / Q000378:metabolism; D002338:Carotenoids / Q000378:metabolism*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000209:etiology / Q000378:metabolism; D005231:Fatty Acids, Unsaturated / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000378:metabolism*; D009262:Nails / Q000378:metabolism; D012307:Risk Factors; D012643:Selenium / Q000378:metabolism; D012907:Smoking / Q000009:adverse effects; D014034:Toes; D019207:beta Carotene
D000975:Antioxidants; D005231:Fatty Acids, Unsaturated; D019207:beta Carotene; D002338:Carotenoids; D012643:Selenium