Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure
Por:
Miro, O, Estruch, R, Martin-Sanchez, FJ, Gil, V, Jacob, J, Herrero-Puente, P, Mateo, SH, Aguirre, A, Andueza, JA, Llorens, P
Publicada:
1 ene 2018
Resumen:
OBJECTIVES The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet).
ACKGROUND It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF.
METHODS We designed a prospective study that included consecutive patients diagnosed with AHF in 7 Spanish emergency departments (EDs). Patients were included if they or their relatives were able to answer a 14-point score of adherence to the MedDiet, which classified patients as adherents (>= 9 points) or nonadherents (<= 8 points). The primary endpoint was all-cause mortality at the end of follow-up, and secondary endpoints were 1-year ED revisit without hospitalization, rehospitalization, death, and a combined endpoint of all these variables for patients discharged after the index episode. Unadjusted and adjusted hazard ratios (HRs) were calculated.
RESULTS We included 991 patients (mean age of 80 +/- 10 years, 57.8% women); 523 (52.9%) of whom were adherent to the MedDiet. After a mean follow-up period of 2.1 +/- 1.3 years, no differences were observed in survival between adherent and nonadherent patients (HR of adherents [HRadh] = 0.86; 95% confidence interval [CI]: 0.73 to 1.02). The 1-year cumulative ED revisit for the whole cohort was 24.5% (HRadh = 1.10; 95% CI: 0.84 to 1.42), hospitalization 43.7% (HRadh = 0.74; 95% CI: 0.61 to 0.90), death 22.7% (HRadh = 1.05; 95% CI: 0.8 to 1.38), and combined endpoint 66.8% (HRadh = 0.89; 95% CI: 0.76 to 1.04). Adjustment by age, hypertension, peripheral arterial disease, previous episodes of AHF, treatment with statins, air-room pulsioxymetry, and need for ventilation support in the ED rendered similar results, with no statistically significant differences in mortality (HRadh = 0.94; 95% CI: 0.80 to 1.13) and persistence of lower 1-year hospitalization for adherents (HRadh = 0.76; 95% CI: 0.62 to 0.93).
CONCLUSIONS Adherence to the MedDiet did not influence long-term mortality after an episode of AHF, but it was associated with decreased rates of rehospitalization during the next year. (C) 2018 by the American College of Cardiology Foundation.
Filiaciones:
Miro, O:
Hosp Clin Barcelona, IDIBAPS, Emergency Dept, Barcelona, Spain
Univ Barcelona, Sch Med, Barcelona, Spain
Estruch, R:
Univ Barcelona, Sch Med, Barcelona, Spain
Hosp Clin Barcelona, IDIBAPS, Dept Internal Med, Barcelona, Spain
Inst Salud Carlos III, CIBER OBN, Physiopathol Obes & Nutr, Madrid, Spain
Martin-Sanchez, FJ:
Univ Complutense Madrid, Emergency Dept, Hosp Clin San Carlos, Madrid, Spain
Gil, V:
Hosp Clin Barcelona, IDIBAPS, Emergency Dept, Barcelona, Spain
Jacob, J:
Hosp Univ Bellvitge, Emergency Dept, Barcelona, Spain
Herrero-Puente, P:
Hosp Univ Cent Asturias, Emergency Dept, Oviedo, Spain
Mateo, SH:
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Aguirre, A:
Hosp Mar, Emergency Dept, Barcelona, Spain
Andueza, JA:
Hosp Univ Gregorio Maranon, Emergency Dept, Madrid, Spain
Llorens, P:
Hosp Gen Alicante, Emergency Dept, Home Hospitalizat & Short Stay Unit, ISABIAL,FISABIO, Alicante, Spain
Bronze, Green Accepted
|