A study on the relationship between Mediterranean dietary pattern and the risk of acute non-ST-segment elevation myocardial infarction

Zhang Qian; Xiao Li; Guo Chang; Wei Lujia; Wang Xifu; Wang Yunlong; Wu Suping

doi:10.3760/j.issn.1673-4777.2024.01.001

Abstract：Objective To explore the correlation between Mediterranean dietary pattern and the risk of acute non-ST-segment elevation myocardial infarction(NSTEMI).Methods This study was a large case-control study at a single center.A total of 600 patients who were first diagnosed with acute NSTEMI in Beijing Anzhen Hospital,Capital Medical University from January 2017 to December 2020 were collected as the acute NSTEMI group.1:1 match was conducted based on age and gender,and 600 healthy examinees from the physical examination center of our hospital during the same period were selected as the control group;the general datas were compared between the two groups.The alternate Mediterranean diet score(AMEDS)was computed from Food Frequency Questionnaires.All subjects were divided into AMEDS＜4 group,AMEDS 4-5 group,and AMEDS ≥ 6 group based on AMEDS.The risks of acute NSTEMI were analyzed overall and in different AMEDS groups,and the correlation between different types of food in AMEDS and the risk of acute NSTEMI was analyzed.Results The proportion of patients with hypertension and diabetes history,systolic blood pressure,body mass index,and the proportion of current smokers in the acute NSTEMI group were higher than those in the control group,the proportion of family income ≥120 000 yuan/year,and AMEDS were lower than those in the control group(all P＜0.05).Compared to subjects in the AMEDS＜4 group,the risk of acute NSTEMI was significantly reduced among participants in the AMEDS 4-5 and AMEDS ≥6 groups(adjusted for multiple covariates such as age,gender,years of education,annual family income,medical history,body mass index,blood pressure,hemoglobin,lifestyle,etc.,odds ratio=0.72,95％confidence interval:0.53-0.94,P=0.031;odds ratio=0.62,95％confidence interval:0.47-0.84,P=0.008).Patients were stratified by age and gender,and multivariate regression analysis showed that with the increase of AMEDS,the risk of acute NSTEMI decreased in men and people＜60 years old(all P＜0.05).There were no statistically significant differences in trend between women and people ≥60 years old(all P＞0.05),and there were no statistically significant differences in interaction analysis between layers after interaction analysis(all P＞0.05).The results of AMEDS food category analysis showed that vegetables and fish reduced the risk of acute NSTEMI,and red meat or processed meat increased its risk(odds ratio=0.51,95％confidence interval:0.42-0.66,P＜0.001;odds ratio=0.75,95％confidence interval:0.59-0.94,P=0.010;odds ratio=1.51,95％confidence interval:1.21-1.90,P＜0.001).Conclusions The Mediterranean dietary pattern is associated with the occurrence of acute NSTEMI.High adherence to the modified Mediterranean diet may reduce the risk of acute NSTEMI.