Waldeyer C, et al. - Given the limited data on the association between the Mediterranean diet (MD) and severity of coronary artery disease (CAD), researchers analyzed data from the INTERCATH cohort to examine this link in CAD patients by using the SYNTAX score. Findings revealed an independent association of adherence to MD with a less complex CAD. A significant correlation of hs-CRP with adherence to MD was observed, and this was suggested to represent the vasoprotective impacts of MD. Overall, the protective effect of an MD pattern in cardiovascular disease prevention was supported by the evidence.

Methods

• In the INTERCATH study, which is an observational study, patients undergoing coronary angiography at the University Heart Center Hamburg were included.
• Using the SYNTAX score, coronary morphology was evaluated.
• Lifestyle questionnaire was used to collect dietary data with food frequency questions at baseline.
• An established Mediterranean diet score (MDS) was calculated based on seven dietary characteristics), with a range of 0–28 points, at which 28 points reflect maximal adherence to MD.
• Logistic regression analysis was performed after adjustment for confounding factors, to determine the association of MD with severity of CAD.

Results

• This study included a total of 1,121 patients with median age 70.7 years (interquartile range (IQR) 61.1,77.0), of whom 27% were women.
• Data showed that CV risk factors were distributed as expected for a CAD cohort (31.3% diabetes, 81.1% arterial hypertension, 34.0% smoking, median BMI 26.6 kg/m²(IQR 24.1, 30.3), median LDL-C 87 mg/dL (IQR 65.0,116,6).
• Findings demonstrated that the strongest correlation with MDS was found for log (hs-CRP) among all variables included (r = -0.21, p < 0.001).
• Researchers observed that adherence to MD (represented by a higher MDS) was significantly related to a lower probability of a medium/high risk SYNTAX score of ≥ 23 with an odds ratio (OR) of 0.923 per point increase of MDS (95% confidence interval 0.869–0.979; p=0.0079).
• Even after adjustment for cardiovascular risk factors, this link continued to be significant (OR 0.934, 95% CI 0.877–0.995, p=0.035).
• They found the association was no longer significant after further adjustment for log (hs-CRP) (OR 0.955 (0.893–1.022, p=0.19).