The relationship between adherence to the Mediterranean diet and the severity and short-term prognosis of acute coronary syndromes (ACS): The Greek Study of ACS (The GREECS).
BACKGROUND
Although adherence to the Mediterranean diet has long been associated with lower incidence of various chronic diseases among apparently healthy individuals, its relationship with the severity and short prognosis (30 d) of patients with cardiovascular disease has rarely been investigated.


OBJECTIVE
We sought to evaluate the association between adherence to the Mediterranean diet and the severity and prognosis of acute coronary syndromes.


METHODS
From October 2003 to September 2004, a sample of 6 hospitals located in several urban and rural Greek regions was selected, and almost all survivors after an acute coronary syndrome were enrolled into the study (2172 patients were included in the study; 76% were men and 24% women). Adherence to the Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. Higher values of the score (range 0-55) were closer to the Mediterranean diet. Biochemical indices of myocardial damage were also considered.


RESULTS
Diet score was inversely correlated with entry values of cardiac troponin I (rho = -0.19, P < 0.001), creatine phosphokinase (rho = -0.09, P < 0.001), and creatine phosphokinase-MB (rho = -0.09, P < 0.001). An increment in the diet score was associated with significant decrease in troponin I and creatine phosphokinase-MB levels (P < 0.01) after adjusting for various potential confounders. Moreover, diet score was associated with lower risk of recurrent events (odds ratio = 0.81, 95% confidence interval 0.61-0.98). However, this association became insignificant when the discharge diagnosis of the patients was taken into account.


CONCLUSIONS
Background dietary habits close to the Mediterranean diet seem to be associated with lower severity of coronary heart disease.
Panagiotakos
Demosthenes B
DB
Department of Nutrition-Dietetics, Harokopio University, Athens, Greece. d.b.panagiotakos@usa.net
Arapi
Sophia
S
Pitsavos
Christos
C
Antonoulas
Antonis
A
Mantas
Yannis
Y
Zombolos
Spyros
S
Stefanadis
Christodoulos
C
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000178:diet therapy; D001519:Behavior; D003327:Coronary Disease / Q000178:diet therapy*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D004032:Diet; D038441:Diet, Mediterranean; D015444:Exercise; D005260:Female; D006115:Greece; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000178:diet therapy; D010349:Patient Compliance; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking; D019210:Troponin I / Q000097:blood
D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form