Abstract 13938: Relationships Between ‘Mediterranean’ and ‘Western’ Dietary Patterns and Biomarkers Associated With Increased Cardiovascular Risk in Patients With Stable Coronary Heart Disease in the Global STABILITY Trial
Introduction: In the STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial greater adherence to a Mediterranean dietary pattern (MD) was associated with major cardiovascular (CV) events (MACE) but there was no association between a ‘Western Diet Score’ (WDS) and MACE. The lowest mortality and MACE was in patients with a MD score (MDS) ≥15.
Hypothesis: Low adherence to a MD may be associated with higher plasma levels of biomarkers known to predict adverse CV events.
Methods: At baseline, 15,482 (97.8%) trial participants completed a lifestyle questionnaire. MDS was calculated for increasing consumption of whole grains, fruits, vegetables, legumes, fish, and alcohol, and for less meat. WDS was calculated for increasing consumption of refined grains, sweets and desserts, sugared drinks, and deep-fried foods. In 15,287 of these participants hs C-reactive protein (hs-CRP), hs troponin T (hs-TnT), N-terminal B type natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), cystatin-C, growth differentiation factor-15 (GDF-15) and lipoprotein-associated phospho-lipase A2 (Lp-PLA2) were measured from stored plasma samples taken at baseline. The ratios of the geometric mean level of each biomarker by diet group are reported adjusted for age, gender, darapladib treatment, geographic region, markers of disease severity, and CV risk factors including body mass index, diabetes, hypertension, and low and high-density lipoprotein cholesterol.
Results: Lower MDS (13-14/ ≥15 and ≤12/ ≥15 respectively) was associated with higher hs-CRP 1.12 (95%CI 1.05; 1.19), 1.18 (1.11; 1.25), cystatin-C 1.01 (1.00; 1.02), 1.03 (1.01; 1.04), GDF-15 1.05 (1.02; 1.07), 1.06 (1.04; 1.09) and LpPLA2 1.02 (1.01; 1.04), 1.04 (1.02; 1.06) after adjusting for all co-variables (p<0.01 for all). IL-6, hs-TnT and NT-proBNP were not independently associated with MDS. WDS was not independently associated with higher plasma levels of any biomarkers.
Conclusions: MD may be associated with lower CV risk in part by effects on inflammatory activity and pathways of cellular function independent of plasma lipids. Greater consumption of food in the WDS was not associated with adverse CV events or with biomarkers known to be associated with risk.
Author Disclosures: R.A. Stewart: Research Grant; Modest; GlaxoSmithKline. Other; Modest; GlaxoSmithKline (Non-financial Support). H.D. White: Consultant/Advisory Board; Modest; AstraZeneca. Research Grant; Significant; Sanofi Aventis, Eli Lilly, NIH, Merck Sharpe & Dohme, GSK, Daiichi Sankyo Pharma Development, Astra Zeneca. J. Benatar: None. N. Danchin: Research Grant; Significant; AstraZeneca, Daiichi Sankyo, Eli Lilly, Bayer, Sanofi, Amgen. Speakers Bureau; Modest; Amgen, Bayer, BMS, Eli-Lilly, MSD, Sanofi. Speakers Bureau; Significant; AstraZeneca. Honoraria; Modest; Amgen, AstraZeneca, Bayer, Daiichi Sankyo, GSK, MSD, Novo Nordisk, Sanofi, Servier. E. Hagström: Research Grant; Significant; GlaxoSmithKline, AstraZeneca, Amgen, Sanofi. Consultant/Advisory Board; Modest; Sanofi, Ariad. Other; Modest; Amgen (Lecture fees). C. Held: Research Grant; Significant; GlaxoSmithKline, Merck, Roche, Bristol-Myers Squibb, AstraZeneca. Speakers Bureau; Modest; AstraZeneca. S. Husted: Other Research Support; Modest; GlaxoSmithKline, Boehringer Ingelheim, Pfizer. Consultant/Advisory Board; Modest; AstraZeneca, Bristol-Myers Squibb, Pfizer, Bayer. E. Lonn: Research Grant; Significant; AstraZeneca, Amgen, Eli Lilly, Bayer. Honoraria; Modest; Amgen, Sanofi. N. Hadziosmanovic: None. O. Vedin: Research Grant; Significant; GlaxoSmithKline. Other; Modest; Fresenius (Lecture Fees), Novartis (Lecture Fees). D. Watson: Employment; Significant; GlaxoSmithKline. Ownership Interest; Significant; GlaxoSmithKline. A. Siegbahn: Research Grant; Significant; Bristol-Myers Squibb, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline. L. Wallentin: Honoraria; Modest; Boehringer-Ingelheim, AstraZeneca, Bristol-Myers Squibb/Pfizer, GlaxoSmithKline. Consultant/Advisory Board; Modest; Merck & Co, Boehringer-Ingelheim, AstraZeneca, GlaxoSmithKline, Bristol-Myers Squibb/Pfizer. Research Grant; Significant; AstraZeneca, Merck & Co, Boehringer-Ingelheim, Bristol-Myers Squibb/Pfizer, GlaxoSmithKline.
- © 2015 by American Heart Association, Inc.