Randomised controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: Results of one year follow up

Abstract

Objective - To test whether a fat reduced diet rich in soluble dietary fibre, antioxidant vitamins, and minerals reduces complications and mortality after acute myocardial infarction. Design - Randomised, single blind, controlled trial. Setting - Primary and secondary care research centre for patients with myocardial infarction. Subjects - 505 patients with suspected acute myocardial infarction. Those with definite or possible acute myocardial infarction and unstable angina based on World Health Organisation criteria were assigned to diet A (n=204) or diet B (n=202) within 24-48 hours of infarction. Interventions - Both groups were advised to follow a fat reduced diet. Group A was also advised to eat more fruit, vegetables, nuts, and grain products. Main outcome measures - Mortality from cardiac disease and other causes. Serum lipid concentrations and compliance with diet. Results - Blood lipoprotein concentrations and body weight fell significantly in patients in group A compared with those in group B (cholesterol fell by 0·74 mmol/1 in group A v 0·32 mmol/1 in group B, 95% confidence interval of difference 0·14 to 0·70, and weight by 7·1 v 3·0 kg, 0·52 to 7·68). The incidence of cardiac events was significantly lower in group A than group B (50 v 82 patients, p<0·001). Group A also had lower total mortality (21 v 38 died, p<0·01) than group B. Conclusions - Comprehensive dietary changes in conjunction with weight loss immediately after acute myocardial infarction may modulate blood lipoproteins and significantly reduce complications and mortality after one year.