title: Better diet quality and decreased mortality among myocardial infarction survivors.
abstract: OBJECTIVE
  Information about diet after myocardial infarction (MI) and mortality is limited, despite the growing number of MI survivors in the United States.
  
  
  OBJECTIVE
  To examine the association of post-MI dietary quality and changes from pre- to post-MI with all-cause and cardiovascular mortality among MI survivors.
  
  
  METHODS
  We included 2258 women from the Nurses' Health Study and 1840 men from the Health Professionals Follow-up Study. Participants had survived an initial MI during the study follow-up period and completed the pre- and post-MI food frequency questionnaire. Diet quality was measured using Alternative Healthy Eating Index 2010 (AHEI2010), which consists of food and nutrients associated with the risk of chronic disease reported in the literature. We adjusted for medication use, medical history, and lifestyle risk factors using Cox proportional hazards regression models.
  
  
  METHODS
  All-cause and cardiovascular mortality.
  
  
  RESULTS
  During follow-up, we confirmed 682 all-cause deaths for women and 451 for men. The median survival time after the initial MI onset was 8.7 years for women and 9.0 years for men. When the results were pooled, the adjusted hazard ratio (HR) was 0.76 (95% CI, 0.60-0.96) for all-cause mortality and 0.73 (95% CI, 0.51-1.04) for cardiovascular mortality, comparing the extreme quintiles of post-MI AHEI2010. A greater increase in the AHEI2010 score from pre- to post-MI was significantly associated with lower all-cause mortality (pooled HR, 0.71; 95% CI, 0.56-0.91) and cardiovascular mortality (pooled HR, 0.60; 95% CI, 0.41- 0.86), comparing the extreme quintiles. The adjusted HRs associated with post-MI AHEI2010 were 0.73 (95% CI, 0.58-0.93) for all-cause mortality and 0.81 (95% CI, 0.64-1.04) for cardiovascular mortality when the alcohol component was excluded.
  
  
  CONCLUSIONS
  Myocardial infarction survivors who consume a higher-quality diet, which has been associated with a lower risk of coronary heart disease in primary prevention, have lower subsequent all-cause mortality.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Chiuve
authors.forename: Alan
authors.initials: A
authors.lastname: Flint
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Pai
authors.forename: John P
authors.initials: JP
authors.lastname: Forman
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*