Relationship between empirical dietary inflammatory potential and myocardial infarction.

BACKGROUND: Inflammation plays an important role in developing myocardial infarction (MI). This study examined whether a proinflammatory diet is associated with increased risk of myocardial infarction. METHODS: This analysis included 7,134 participants (60.3 ± 13.6 years; 51.8% females) from the third National Health and Nutrition Examination (NHANES-III). The proinflammatory diet was assessed using the empirical dietary inflammatory potential (EDIP) score, calculated from the Food Frequency Questionnaire. MI was defined from electrocardiograms (ECGs) using the Minnesota ECG Classification. The cross-sectional association between levels of EDIP modeled as tertiles and per 1-standard deviation (1-SD) increase in separate models with the risk of MI using multivariable logistic regression analysis. RESULTS: Participants with MI (n=230 (3.2%)) had higher levels of EDIP scores compared to those without MI (0.148 ± 0.241 score units vs. 0.106 ± 0.256 score units, respectively; p=0.01). In multivariable-adjusted models, each 1-SD (0.256 score unit) increase in EDIP was associated with 20% increased odds of MI (OR (95% CI); 1.20 (1.05 to 1.38)). Odds of MI increased as the levels of EDIP tertiles increased, indicating a dose-response relationship (OR (95% CI); 1,41 (1.0 to 1.99) and 1.48 (1.05 to 2.09), respectively). These results were consistent among subgroups of the participants stratified by hypertension, obesity, diabetes, and hyperlipidemia, but effect modification by smoking status was observed (interaction p-value=0.04). CONCLUSIONS: Dietary patterns with high proinflammatory properties are associated with an increased risk of MI. Advocating for low proinflammatory dietary patterns could be an approach for preventing coronary heart disease.

Vitamin D with calcium supplementation and risk of atrial fibrillation in postmenopausal women.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia in adults. Although vitamin D deficiency is associated with AF risk factors, retrospective studies of association with AF have shown mixed results. We sought to determine the efficacy of calcium and vitamin D (CaD) supplementation for AF prevention in a randomized trial. METHODS: We performed a secondary analysis of the Women's Health Initiative trial on CaD supplementation versus placebo. We linked participants to their Medicare claims to ascertain incident AF. RESULTS: Among 16,801 included participants, there were 1,453 (8.6%) cases of incident AF over an average of 4.5 years, at an average rate of 19.9 events per 1,000 person-years. We found no significant difference in incident AF rates between the CaD and placebo arms (hazard ratio 1.02 for CaD vs placebo, 95% CI 0.92-1.13). After multivariate adjustment, there was no significant association between baseline 25-hydroxyvitamin D serum levels and incident AF (hazard ratio 0.92 for lowest subgroup vs highest subgroup, 95% CI 0.66-1.28). CONCLUSIONS: We present the first analysis of a large randomized trial of daily vitamin D supplementation for AF prevention. We found that CaD had no effect on incidence of AF in Women's Health Initiative CaD trial participants. We also found that baseline serum 25-hydroxyvitamin D level was not predictive of long-term incident AF risk.