Introduction: The impact of diet on atherosclerosis progression is well established although, the independent predictive value of unhealthy diet in the prognosis and severity of CAD has not been incorporate in clinical practice.
Hypothesis: Dietary patterns significantly influence CAD severity.Methods: In this cohort study we included 188 consecutive symptomatic stable CAD patients. The diagnosis of CAD was based on coronary angiography and patients were categorized as having severe CAD and non-severe CAD. The diagnosis of severe CAD was based on the presence of either left main coronary artery disease (stenosis≥50%), or three-vessel coronary artery disease, or two-vessel coronary artery disease marked by stenosis of the proximal left anterior descending artery ≥70%. Moreover, Gensini score was used to quantitatively evaluate severity of CAD. Among several demographics and clinical characteristics all subjects were tested with a validated semi quantitative food frequency questionnaire.
Results: Concerning baseline demographic characteristics there was no difference between subjects with severe CAD and non-severe CAD while, the prevalence of severe CAD was higher in current smokers compared to non-smokers. Principal component analysis revealed 8 distinct dietary patterns. The first component-western dietary pattern (increased intake of fat, red meat and carbohydrates and minimal consumption of fruits vegetables and green leafy) was predictive of severe CAD (AUC:0.73, 95% CIs:0.64-0.83, p<0.001) and more interestingly, can increase the discriminative ability of a multivariate model based on all major risk factors.
Conclusion: The unhealthy western type of diet is associated with the severity and extent of coronary artery lesions in patients with stable CAD. These findings highlight the importance of accessing dietary patterns when calculating cardiovascular risk and the importance of dietary habits in the management of cardiovascular patients