Short-term prognosis of patients with acute coronary syndromes through the evaluation of physical activity status, the adoption of Mediterranean diet and smoking habits: the Greek Acute Coronary Syndromes (GREECS) study.
OBJECTIVE
Our aim was to evaluate whether healthy dietary habits, physical activity and non-smoking are associated with less severe acute coronary syndromes and better short-term prognosis.


METHODS
From October 2003 to September 2004, 2172 patients (1649 males), hospitalized for severe acute coronary syndromes in six major hospitals in Greece were included in the study. The severity of severe acute coronary syndromes was assessed through troponin-I and maximum creatinine kinase MB levels, while 30-day recurrent event rate (death or rehospitalization for cardiovascular disease, angioplasty or coronary artery bypass surgery) was used to evaluate the prognosis of the patients. A 'healthy index' that assessed adherence to the Mediterranean diet, moderate alcohol intake, physical activity and abstinence from smoking was developed (range 0-4).


RESULTS
One unit increment in the healthy index was associated with -12.4+/-2.4 ng/ml decrease in troponin I levels (P=0.001) and -9.7+/-2.5 ng/ml decrease in maximum creatinine kinase MB levels (P=0.001). The in-hospital mortality rate was 3.2% in males and 5.7% in females (i.e. overall 82 deaths, P=0.009); during the first 30 days following hospitalization the event rate was 15.7% in males and 16.3% in females (P=0.001). Values of the healthy index above one (i.e. presence of two or more protective factors) seemed to be associated with 44-84% lower risk of having recurrent events (P<0.001), even after various adjustments were made.


CONCLUSIONS
Among patients who had had severe acute coronary syndromes, a healthy lifestyle seemed to be associated with less severe cardiac events and lower risk of death or rehospitalization 30 days after the event.
Panagiotakos
Demosthenes B
DB
Department of Nutrition, Dietetics, Harokopio University, Greece. d.b.panagiotakos@usa.net
Pitsavos
Christos
C
Stefanadis
Christodoulos
C
D000208:Acute Disease; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000097:blood / Q000401:mortality* / Q000517:prevention & control*; D016009:Chi-Square Distribution; D052279:Creatine Kinase, MB Form / Q000097:blood; D038441:Diet, Mediterranean; D005260:Female; D006115:Greece / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000517:prevention & control*; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D019210:Troponin I / Q000097:blood
D019210:Troponin I; D052279:Creatine Kinase, MB Form