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Biomedical subjects

Christos Pitsavos

Publications and source records attributed to Christos Pitsavos.

At least 37 records · Page 2Linked to original sources

Correlates of BMI misreporting among apparently healthy individuals: the ATTICA study.

OBJECTIVE: The aim of this study was to investigate correlates of misreporting in BMI, based on self-reported weight and height, in a randomly selected population sample of Greek adults and to evaluate the effect of obesity status misclassification on the associations between obesity and disease. RESEARCH METHODS AND PROCEDURES: During 2001 to 2002, we randomly enrolled 1514 men (18 to 87 years old) and 1528 women (18 to 89 years old) from the Attica area, Greece; the sampling was stratified by the age-sex distribution of the region. Various sociodemographic, clinical, and psychological characteristics were self-reported, and weight and height were measured and recorded in all participants. RESULTS: The proportions of true positives and true negatives for correct obesity status identification were 62% and 97%, respectively. Women were 9 times more likely to be under-reporters than men, whereas men were 7.5 times more likely to be over-reporters. A 10-year increase in age was associated with a 48% higher likelihood of being an under-reporter and 26% lower likelihood of being an over-reporter, irrespective of sex and other characteristics of the participants. Clinical status, such as the presence of hypertension and diabetes, was associated with under-reporting of body weight. Furthermore, the use of self-reported data may substantially exaggerate associations between obesity and obesity-related diseases, such as diabetes, hypercholesterolemia, and hypertension. DISCUSSION: The study indicates that, apart from age and sex, disease status may be another factor that influences misreporting of obesity status, with diabetic and hypertensive people to be more likely to under-report their overweight. Use of self-reported data may bias obesity-disease associations.

Adolescent↗

Different genes and polymorphisms affecting high-density lipoprotein cholesterol levels in Greek familial hypercholesterolemia patients.

Familial Hypercholesterolemia (FH) is a genetic disorder characterized by high low-density lipoprotein cholesterol (LDL-C) concentrations that frequently gives rise to premature coronary artery disease. The clinical expression of FH is highly variable, even in patients carrying the same LDL receptor gene mutation. This variability may be due to environmental and other genetic factors. We investigated the effect of APOCIII T1100C, FV Gln506Arg, ADRB2 Glu27Gln, SELE Ser128Arg, SELE Leu554Phe, and ENaCa Ala663Thr polymorphisms on the HDL-C variations in 84 patients with FH. For ApoCIII T1100C, subjects with the TT genotype presented higher HDL-C levels than the other genotype groups (p = 0.046). Similarly the presence of the Gln allele in ADRB2 27 Glu/Gln heterozygotes and ADRB2 27 Gln/Gln homozygotes was associated with higher HDL-C levels (p = 0.014). Among the other polymorphisms tested, none of them were associated with variations in HDL-C levels. The influence of each polymorphism on lipid concentrations was evaluated with linear regression analyses after adjustment for age and sex. Among the variables studied including total cholesterol, LDL-C, high-density lipoprotein (HDL)-C, triglycerides, apolipoprotein A (Apo-A) and B (Apo-B), and lipoprotein alpha (LP alpha), HDL-C concentration was significantly different in models applied for polymorphisms ApoCIII T1100C, FV Gln506Arg, and ADRB2 Glu27Gln (p = 0.01, p = 0.018, p = 0.04, respectively). These results suggest that HDL-C levels in FH heterozygotes may be affected by several different genetic variants.

Adult↗

Asymmetrical dimethylarginine regulates endothelial function in methionine-induced but not in chronic homocystinemia in humans: effect of oxidative stress and proinflammatory cytokines.

BACKGROUND: Homocystinemia is a metabolic abnormality associated with endothelial dysfunction and increased cardiovascular disease risk. The underlying mechanisms of these effects, however, are obscure. OBJECTIVE: We examined the effect of asymmetrical dimethylarginine (ADMA) on endothelial dysfunction in methionine-induced and chronic homocystinemia and evaluated the regulatory role of oxidative stress and proinflammatory cytokines on the release of ADMA. DESIGN: In this double-blind, placebo-controlled parallel group study, 30 subjects of both sexes (15 with homocystinemia and 15 healthy controls) underwent methionine loading, with simultaneous administration of a combination of vitamin C (2 g) plus alpha-tocopherol (800 IU) or placebo. Endothelial function in forearm resistance vessels and concentrations of ADMA, oxidized LDL, and proinflammatory cytokines were determined at baseline and 4 h after methionine loading. RESULTS: Both chronic and methionine-induced homocystinemia were associated with increased oxidized LDL (P < 0.01), higher expression of the proinflammatory cytokine interleukin 6 (P < 0.05), and endothelial dysfunction (P < 0.01). Although ADMA rapidly increased in acute homocystinemia (P < 0.01) and was correlated with forearm hyperemic response at 4 h after methionine loading (r = -0.722, P = 0.0001), it was not higher in subjects with high versus low fasting homocysteine. High-dose antioxidant treatment prevented methionine-induced elevation of oxidized LDL and interleukin 6 but failed to prevent the increase in ADMA or endothelial dysfunction. CONCLUSIONS: Both chronic and methionine-induced homocystinemia are characterized by increased oxidative stress and proinflammatory cytokines, which may contribute to the development of endothelial dysfunction. However, the ADMA pathway is activated only in acute homocystinemia by mechanisms not mediated by oxidized LDL or proinflammatory stimuli.

Adult↗

Modelling dairy intake on the development of acute coronary syndromes: the CARDIO2000 study.

BACKGROUND: Dairy consumption may be associated with a small but worthwhile reduction in cardiovascular disease risk, but results from epidemiological studies are inconsistent. The aim of the present study was to evaluate the association between dairy consumption and the prevalence of a first, non-fatal event of an acute coronary syndrome, in a Greek sample. DESIGN: Seven hundred male and 148 female patients with first event of an acute coronary syndrome and 1078 population-based controls, age and sex matched, were randomly selected. METHODS: Detailed information regarding their medical records, alcohol intake, physical activity and smoking habits was recorded. Nutritional habits were evaluated with a semi-quantitative food-frequency questionnaire. Multiple logistic regression analysis estimated the odds ratio of having acute coronary syndrome by level of dairy intake, after taking into account the effect of several confounders. RESULTS: An inverse relationship was observed between dairy products consumption and odds of having acute coronary syndrome. One portion increase in weekly dairy products intake was associated with 12% lower likelihood of having acute coronary syndrome, after controlling for various potential confounders (P<0.001). Cut-off analysis showed that 7.4 portions per week are the optimal consumption that benefits people from having acute coronary syndrome. CONCLUSIONS: Dairy consumption seems to offer significant protection against coronary heart disease, irrespective of various clinical, lifestyle and other characteristics of the participants.

Case-Control Studies↗

Short-term effects of atmospheric temperature and humidity on morbidity from acute coronary syndromes in free of air pollution rural Greece.

STUDY OBJECTIVE: An evaluation of the effect of ambient temperature on morbidity from acute coronary syndromes (ACS) while avoiding confounding by air pollution. DESIGN: An ecological study in rural Greece. METHODS: Daily admissions to hospital because of ACS were recorded for 1 year and analysed versus daily temperature and humidity. RESULTS: For a 1 degrees C decrease in temperature there was a 1.6% (95% confidence interval 0.9-2.2%) increase in admissions. This effect was more prominent in the elderly. No difference was detected according to sex or type of ACS. CONCLUSION: It is important to implement measures against cold in coronary heart disease prevention, irrespective of air pollution.

Air Pollution↗

Short-term prognosis of patients with acute coronary syndromes through the evaluation of physical activity status, the adoption of Mediterranean diet and smoking habits: the Greek Acute Coronary Syndromes (GREECS) study.

PURPOSE: Our aim was to evaluate whether healthy dietary habits, physical activity and non-smoking are associated with less severe acute coronary syndromes and better short-term prognosis. SUBJECTS AND METHODS: From October 2003 to September 2004, 2172 patients (1649 males), hospitalized for severe acute coronary syndromes in six major hospitals in Greece were included in the study. The severity of severe acute coronary syndromes was assessed through troponin-I and maximum creatinine kinase MB levels, while 30-day recurrent event rate (death or rehospitalization for cardiovascular disease, angioplasty or coronary artery bypass surgery) was used to evaluate the prognosis of the patients. A 'healthy index' that assessed adherence to the Mediterranean diet, moderate alcohol intake, physical activity and abstinence from smoking was developed (range 0-4). RESULTS: One unit increment in the healthy index was associated with -12.4+/-2.4 ng/ml decrease in troponin I levels (P=0.001) and -9.7+/-2.5 ng/ml decrease in maximum creatinine kinase MB levels (P=0.001). The in-hospital mortality rate was 3.2% in males and 5.7% in females (i.e. overall 82 deaths, P=0.009); during the first 30 days following hospitalization the event rate was 15.7% in males and 16.3% in females (P=0.001). Values of the healthy index above one (i.e. presence of two or more protective factors) seemed to be associated with 44-84% lower risk of having recurrent events (P<0.001), even after various adjustments were made. CONCLUSION: Among patients who had had severe acute coronary syndromes, a healthy lifestyle seemed to be associated with less severe cardiac events and lower risk of death or rehospitalization 30 days after the event.

Acute Disease↗

Diastolic function in young patients with beta-thalassemia major: an echocardiographic study.

OBJECTIVE: We aimed to evaluate myocardial diastolic function in patients with beta-thalassemia major (beta-TM) using pulsed-tissue Doppler imaging (TDI) and flow propagation (VP), in relation to BNP levels. METHODS: We enrolled 192 consecutive patients with beta-TM (88 men (25 +/- 6 years) and 104 women (26 +/- 6 years), with normal left ventricular (LV) systolic function. By TDI, diastolic myocardial velocities were sampled at the lateral section of the mitral annulus (Smv, Emv, Amv). From the apical four-chamber view diastolic transmitral flow velocities, including measures of E- and A-waves were performed. The propagation velocity of early flow into the LV cavity was measured by color M-mode Doppler. Plasma BNP levels were measured in all patients. RESULTS: A nonlinear relationship was found between BNP levels and E/A ratio (beta coefficient for the second-order term = 1.4 +/- 0.4, P = 0.001). We also found a positive association of BNP levels with Amv (r = 0.28, P = 0.023), and a reverse with Smv (r =-0.59, P = 0.01) and Emv/Amv (r =-0.36, P = 0.019). Moreover, an inverse relationship was observed between BNP and Vp (r =-0.43, P = 0.012) levels. Finally, a strong positive linear relationship was found between E/Vp ratio and BNP levels (r = 0.76, P < 0.001). CONCLUSION: A U-curved association of E/A ratio of transmitral Doppler velocity was revealed with BNP levels, while the tissue Doppler of the Emv/Amv of the mitral annulus movement showed a negative linear association with BNP levels.

Adult↗

Polymorphisms associated with apolipoprotein B levels in Greek patients with familial hypercholesterolemia.

BACKGROUND: Familial hypercholesterolemia (FH) is a genetic disorder characterized by high low-density lipoprotein-cholesterol (LDL-C) concentrations, which frequently gives rise to premature coronary artery disease. The clinical expression of FH is highly variable, even in patients carrying the same LDL receptor (LDLR) gene mutation. This variability may be due to environmental and other genetic factors. METHODS: We investigated paraoxonase 2 (PON 2) Ser311Cys, lipoprotein lipase (LPL) Asn291Ser, plasminogen activator inhibitor-1 (PAI-1) T11053G, beta-fibrinogen (FGB) -455 G>A and nitric oxide synthase gene (NOS) -922 A>G polymorphisms in 84 patients with FH. The effect of polymorphisms as independent factors of high lipid values was evaluated. RESULTS: The PON 2 Cys311 allele was correlated with high total cholesterol and LDL-C and apolipoprotein B levels, while LPL Asn291, PAI-1 T11053, FGB -455 G and NOS -922 A alleles were correlated with high apolipoprotein B levels. CONCLUSIONS: These results suggest that apolipoprotein B levels in FH heterozygotes may be affected by several different genetic variants.

Adult↗

Dietary habits in a Greek sample of men and women: the ATTICA study.

OBJECTIVE: Although there are several dietary guidelines accepted at the international and national level, there are indications that dietary habits in Greece have been changing, moving away from the traditional Mediterranean diet pattern. The aim of this work was to evaluate the dietary habits of a randomly selected sample from the general adult population, in Greece. SUBJECTS: The "ATTICA" study is a prospective health and nutrition survey. For the purpose of this study, 3,042 adults, from whom 1514 were men (48%) and 1,528 were women (52%), were selected from the greater Athens area during 2001 and 2002. The assessment of the dietary habits was carried out using a validated food frequency questionnaire. RESULTS: Dietary intakes of red meat and sweets were higher (p<0.005), and dietary intakes of fish, poultry, dairy products, vegetables, and cereals were lower (p<0.05) than the ones recommended by the Hellenic Ministry of Health. CONCLUSION: The results from the present study indicate a change in the dietary habits towards an unhealthier type of diet.

Diet, Mediterranean↗

Association between hostility and plasma total homocysteine concentrations in a general population sample.

OBJECTIVE: The present study focuses on testing the association of hostility with plasma homocysteine levels in a general population sample. METHOD: Four hundred and ten healthy adults (200 men and 210 women), participating in a health survey in Greece, had blood samples taken for homocysteine concentrations and also completed a multidimensional hostility questionnaire, assessing direction of hostility ('extra- and intropunitive') as well as total hostility and its ingredients, i.e. urge to act out hostility, criticism of others, delusional hostility, self-criticism and delusional guilt. Multivariate relationship was tested between hostility components and homocysteine, after statistically controlling for potential confounders such as age, gender, educational status, smoking and body mass index. RESULTS: Total hostility, delusional guilt as well as extrapunitive direction of hostility were positively related to homocysteine levels. Self-criticism was negatively related to homocysteine. CONCLUSION: The study provides further evidence that particular dimensions of hostility are associated with increased plasma homocysteine levels, thus deserving a place within the spectrum of the coronary heart disease risk factors.

Adult↗

Endothelial dysfunction and inflammatory process in transfusion-dependent patients with beta-thalassemia major.

BACKGROUND: Beta-thalassemia major is associated with increased cardiovascular risk, although the underlying mechanisms remain unclear. We examined endothelial function and serum levels of inflammatory mediators in transfusion-dependent patients with beta-thalassemia major. METHODS: The study population consisted of 67 patients with homozygous beta-thalassemia major, (aged 24.6+/-0.7 years) and 71 healthy age and sex matched controls. Forearm blood flow was measured with gauge-strain plethysmography. Forearm vasodilatory response to reactive hyperemia (RH%) or to nitrate (NTG%) was expressed as the percentage change of forearm blood flow from baseline to the maximum flow during reactive hyperemia or sublingual nitroglycerin, respectively. Serum levels of interleukin 6 (IL-6), soluble vascular cell adhesion molecule (sVCAM-1) and soluble intercellular adhesion molecule (sICAM-1) were determined with ELISA. RESULTS: Patients had significantly lower levels of total cholesterol (125+/-4.5 vs. 207+/-7 mg/ml, p<0.01), ApoA1 (120+/-3 vs. 129+/-5 mg/ml, p<0.05), ApoB (60.5+/-2 vs. 95+/-4 mg/ml, p<0.01), ApoE (3+/-2 vs. 4+/-0.2 mg/ml, p<0.01) and Lp(a) (7.9+/-1.3 vs. 14.5+/-3.2 mg/ml, p<0.01) than controls. IL-6 levels were significantly higher in patients (3.03+/-0.31 pg/ml) than controls (1.15+/-0.15 pg/ml, p<0.01). Similarly, sVCAM-1 and sICAM-1 levels were significantly higher in patients (513+/-31 and 368+/-25.5 ng/ml, respectively) than controls (333+/-13.8 and 272+/-14.05 ng/ml, respectively, p<0.01 for both). Maximum hyperemic forearm blood flow and RH% were lower in patients (7.1+/-0.3 ml/100 ml tissue/min and 49+/-2.8%, respectively) than controls (8.26+/-0.32 ml/100 ml tissue/min and 86.3+/-5.57%, respectively, p<0.01 for both). CONCLUSIONS: Beta-thalassemia major is associated with impaired endothelial function and increased levels of IL-6, sVCAM-1 and sICAM-1, suggesting a potential role of inflammation and endothelial dysfunction in the complications of the disease.

Apolipoprotein A-I↗

Interaction between Mediterranean diet and methylenetetrahydrofolate reductase C677T mutation on oxidized low density lipoprotein concentrations: the ATTICA study.

BACKGROUND: The oxidative modification of low-density lipoprotein (LDL) has been suggested to be a key element in atherogenesis, while methylenetetrahydrofolate reductase (MTHFR) C677T mutation has been associated with the development of coronary heart disease. We evaluated whether adoption of a Mediterranean type of diet is associated with oxidized LDL levels, as well as the role of MTHFR C677T mutation in this relationship. METHODS: We studied demographics, lifestyle, clinical, biochemical and genetic data from 322 men (46+/-13 years) and 252 women (45+/-14 years), without any clinical evidence of cardiovascular disease, from the Attica region, Greece (i.e. the ATTICA study). Among the other parameters we also measured oxidized (ox)-LDL levels, and the distribution of MTHFR. Adherence to the Mediterranean diet was evaluated by a special diet score. RESULTS: The distribution of MTHFR genotypes was: 41% for homozygous normal (CC) genotype, 48% for heterozygous (CT) and 11% for homozygous mutant (TT) genotype. Ox-LDL levels were higher in TT as compared to CC and CT (70.8+/-26 vs. 51.0+/-26 vs. 63.7+/-24 mg/dl, p<0.001). Greater adherence to the Mediterranean diet was inversely associated with ox-LDL levels (standardized beta=-0.34, p<0.001), after controlling for several confounding variables; however, stratified analysis revealed that adherence to the Mediterranean diet was associated with lower ox-LDL levels in TT and CT individuals (standardized beta=-0.67, p=0.001 and standardized beta=-0.66, p=0.025, respectively), but not in CC (standardized beta=-0.18, p=0.10), after controlling for several potential confounders. CONCLUSION: The observed gene-to-diet interaction on ox-LDL concentrations may provide a pathophysiological explanation by which a Mediterranean type of diet could influence coronary risk in people with increased oxidative stress.

Coronary Artery Disease↗

The relationship between fish consumption and the risk of developing acute coronary syndromes among smokers: the CARDIO2000 case-control study.

BACKGROUND AND AIM: We sought to investigate the relationship between fish consumption and the risk of developing non-fatal acute coronary syndromes (ACS) among current smokers. METHODS AND RESULTS: During 2000-2001, we conducted the CARDIO2000 case-control study that included patients hospitalized for a first event of ACS and matched (age, sex) individuals without clinical evidence of CHD (controls), from all the Greek regions. In the present analysis we studied data from 519 men (59+/-10 years old) and 45 women (62+/-9 years old) patients, as well as 444 men and 90 women controls, matched for age with the patients that reported current smoking. To evaluate the hypothesis tested we applied conditional logistic regression analysis after controlling for several potential confounders. Overall, 94% of controls and patients reported fish consumption at least once a week. Compared to low fish consumption (<60 g/week), moderate (60-180 g/week) intake was associated with 15% (p<0.05) lower risk of ACS, while increased (180-300 g/week, or >300 g/week) consumption was associated with 18% (p<0.05) and 19% (p = 0.53) higher risk, respectively. CONCLUSION: Moderate fish consumption seems to moderate the deleterious effect of smoking on the occurrence of ACS. However, increased intake does not seem to confer any benefit on coronary risk.

Acute Disease↗

The relation between pulse pressure and cardiovascular mortality in 12,763 middle-aged men from various parts of the world: a 25-year follow-up of the seven countries study.

BACKGROUND: Hypertension is a dominant characteristic in the prediction of cardiovascular diseases (CVDs). We aimed to evaluate the association of blood pressure measurements with CVD mortality among different populations of the world. METHODS: A total of 12 763 men, aged 40 to 59 years, from 7 countries (United States, Japan, Italy, Greece, former Yugoslavia, Finland, and the Netherlands) were surveyed from 1958 to 1964. Follow-up for vital status and causes of death was carried out over 25 years. RESULTS: All baseline blood pressure measurements were the best predictors of CVD mortality, compared with age, physical activity, total serum cholesterol level, body mass index or height, and smoking. Moreover, pulse pressure and diastolic and systolic blood pressures were the best predictors for CVD death, followed by mean and mid blood pressures. The age-adjusted hazard ratio per 10-mm Hg increase in pulse pressure varied among cohorts from 1.19 in the United States (P = .04) to 1.29 in southern Europe (P = .01). Differences among cohorts were not significant. In the pooled cohorts, pulse pressure measurements were also a significant predictor for coronary heart disease (hazard ratio per 10-mm Hg increase, 1.15; P = .04) as well as stroke death (hazard ratio per 10-mm Hg increase, 1.32; P = .01). CONCLUSIONS: Pulse pressure followed by diastolic and systolic blood pressures were the best predictors for CVD mortality among other blood pressures, as well as age, physical activity, total serum cholesterol level, anthropometric indexes, and smoking habits. No significant differences were observed among the different populations studied.

Adult↗

Genetic polymorphism on endothelial nitric oxide synthase affects endothelial activation and inflammatory response during the acute phase of myocardial infarction.

OBJECTIVES: This study sought to evaluate the effect of genetic polymorphism G894T on endothelial nitric oxide synthase (eNOS); on the risk for myocardial infarction (MI); and on the release of von Willebrand factor (vWF), interleukin (IL)-6, IL-1b, and oxidized low-density lipoprotein (ox-LDL) levels during the acute phase of MI and one year after the event. BACKGROUND: Genetic polymorphism G894T on eNOS has been associated with increased cardiovascular risk. However, its role during the acute phase of MI is unknown. METHODS: The study population consisted of 228 patients with a first event of premature MI and 519 matched control patients. One year after the event, 61 patients and 205 control patients were recalled for the follow-up study. Blood sampling was performed during the acute phase and after one year. RESULTS: The risk for MI in 894TT was 1.992 (95% confidence interval [CI], 1.131 to 3.485), p < 0.05 versus GG+GT; 2.038 (95% CI, 1.125 to 3.695), p < 0.05 versus GG; and 2.009 (95% CI, 1.106 to 3.651), p < 0.05 versus GT. During the acute phase, vWF was higher in GT+TT (121.02 +/- 5.47%) versus GG (84.6 +/- 7.1%, p < 0.01), an effect persisting after one year (90.4 +/- 3.8 vs. 73.1 +/- 4.6%, p < 0.01). During the acute phase, GT+TT had higher ox-LDL and IL-6 (131.2 +/- 6.4 IU/l and 8.5 +/- 0.7 pg/ml) compared with GG (101.7 +/- 9.64 IU/l and 6.2 +/- 0.8 pg/ml, p < 0.05 for both), but no difference was found at one year. CONCLUSIONS: G894T polymorphism on the eNOS gene increases the risk for premature MI and modifies the response of vascular endothelium during the acute phase of MI by affecting the release of vWF, IL-6, and oxidative stress status, an effect diminished one year after the event.

Female↗

Effects of combined administration of low dose atorvastatin and vitamin E on inflammatory markers and endothelial function in patients with heart failure.

BACKGROUND: Heart failure has been associated with impaired endothelial function, increased inflammatory process and elevated oxidative stress status. Both statins and vitamin E separately improve endothelial function in patients with hypercholesterolemia and/or advanced atherosclerosis. AIM: To evaluate the effect of atorvastatin alone or in combination with vitamin E on endothelial function and serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and vascular cells adhesion molecule (sVCAM-1) in patients with ischemic heart failure. METHODS: Thirty-eight male patients with ischemic cardiomyopathy were randomly divided into three groups and received either atorvastatin 10 mg/day (n = 14), a combination of atorvastatin 10 mg/day plus vitamin E 400 IU/day (n = 12), or no statin or antioxidant treatment (n=12, controls) for 4 weeks. Forearm blood flow (FBF) was measured using venous occlusion strain-gauge plethysmography. Forearm vasodilatory response to reactive hyperemia (RH%) or to nitrate (NTG%) was defined as the percent change of FBF from rest to the maximum flow during reactive hyperemia or after nitrate administration, respectively. RESULTS: RH% was significantly improved in both the atorvastatin-treated (p < 0.01) and atorvastatin plus vitamin E groups (p < 0.05), but the increase was significantly higher in the atorvastatin-treated group (p < 0.05). Serum levels of IL-6, TNF-alpha and sVCAM-1 were decreased in the atorvastatin-treated group (p < 0.05 for all), but remained unaffected in the other two groups (p = NS for all). CONCLUSIONS: Low dose atorvastatin treatment improves endothelial function and reduces the expression of proinflammatory cytokines and adhesion molecules in patients with ischemic heart failure, an effect partly depressed by vitamin E.

Aged↗

Fish consumption and the risk of developing acute coronary syndromes: the CARDIO2000 study.

OBJECTIVE: The aim of this work was to investigate the association between fish consumption and the development of non-fatal acute coronary syndromes (ACS), in a Mediterranean population. METHODS: During 2000-2001, we randomly and stratified selected, from all Greek regions, 848 hospitalised patients (695 males, 58+/-10 years old and 153 females, 65+/-9 years old) who had a first event of ACS and 1078 paired, by region-sex-age, controls without any clinical symptoms or signs of coronary heart disease. RESULTS: On multivariate logistic regression analysis and, after controlling for several potential confounders, we found that fish consumption less than 150 g/week was associated with 38% lower odds of developing ACS as compared to no consumption (odds ratio=0.62, P-value<0.05). In contrast, moderate (150-300 g/week) and high (>300 g/week) fish consumption was not associated with the developing of the disease (odds ratios=1.10 and 1.01, respectively, P-value>0.1). The benefits from low fish consumption were also significant even amongst current smokers and diabetics. CONCLUSION: Moderate fish consumption was independently associated with a significant reduction in the odds of developing ACS. The strength and consistency of this finding has implications for public health and should be explored further.

Acute Disease↗