No abstract

BackgroundRecently, the clinical importance of dietary inflammatory index (DII) in predicting the inflammatory potential of diet and its role in pathogenesis of several chronic disease including some types of cancers, osteoporosis, cardiovascular disease and renal disease has been proposed. However, its association with the disease severity and progression and cardio-metabolic risk factors among patients candidate for coronary artery bypass graft surgery (CABG) has not been evaluated yet. In the current study, the association of DII with cardiovascular risk factors among patients candidate for CABG has been investigated.MethodsIn the current cross-sectional study, 454 patients aged 35-80 years as candidates of CABG and hospitalized in Tehran Heart Center were enrolled. Anthropometric and demographic characteristics were obtained from all of the participants. Dietary intakes were evaluated with a semi-quantitative food-frequency questionnaire (FFQ) and DII was calculated. Biochemical parameters including hemoglobin (Hb) A1C, serum lipids, albumin, creatinine and high-sensitive C-reactive protein (hs-CRP), lipoprotein (a), creatinine, blood urea nitrogen (BUN), albumin and hematocrit (HCT) were also assessed by commercial laboratory methods. Left ventricular ejection- fraction, number of diseased vessels, New York Heart Association (NYHA) functional class and the European system for cardiac operative risk evaluation (EuroSCORE) were estimated for clinical assessment. One way analysis of variance and chi square tests were used for comparison of demographic parameters between groups. Beta estimates and 95% confidence intervals (CI) for the association between DII and clinical parameters were estimated using linear regression adjusted for the confounders.ResultsAccording to our findings, high DII scores were associated with higher age, lower body mass index (BMI), higher prevalence of diabetes and myocardial infarction (MI) and lower educational attainment (P < 0.05). Male patients in 4th and 3rd quartile of DII had significantly higher total cholesterol (TC), triglyceride (TG), albumin, creatinine, BUN and hs-CRP concentrations and lower high density lipoprotein cholesterol (HDL) concentrations compared with male patients in lower quartiles (P < 0.05). While in female patients, only lipoprotein (a) concentrations and hematocrit (HCT) percentage in the 4th and 2nd quartile were significantly higher than lower quartiles. EuroSCORE was also significantly higher in top quartiles of DII (P = 0.006).ConclusionAs shown in our results, DII was in a positive association with several cardiovascular risk factors. The higher inflammatory potential of diet denoted higher values of serum lipids, CRP and kidney function tests and higher EuroSCORE as a predictor of post-operative mortality. Therefore, DII can be demonstrated as a target of nutritional interventions for ameliorating the CVD risk factors among patients candidate for CABG especially in male patients.

BackgroundStudies have shown an inverse relationship between socioeconomic status (SES) and mortality due to coronary heart disease (CHD). Little is known about this association in Iran. This study aimed to investigate whether mortality after myocardial infarction (MI) varies by SES.MethodsIn a retrospective study, 1283 MI patients who hospitalized in Tehran Heart Center from March 2005 to March 2006 were followed up in March 2008. Demographic, clinical and SES data were collected from case records and by telephone interviews. Multiple logistic regression analysis was performed to estimate the predictive effect of socioeconomic factors on outcome.ResultsIn all 664 patients were studied. Of these, 500 patients were alive and 164 were dead due to MI (64 died at hospital and 100 died at home). The results of regression analysis showed that in addition to treatment (OR = 9.52, 95%CI 4.84-18.7), having diabetes (OR = 1.78, 95% CI 1.12-2.81) or hyperlipidemia (OR = 1.82, 95% CI 1.14-2.90), socioeconomic variables including living area in square per person (lowest level vs. upper level OR = 4.92, 95% CI 2.11-11.4), unemployment (OR = 3.50, 95% CI 1.50-8.13) and education (OR for illiterate patients = 2.51, 95% CI 1.00-6.31) were the most significant contributing factors to increased mortality after MI.ConclusionAlthough the findings should be interpreted with caution, the study results indicated that socioeconomic variables were significant contributing factors to increased mortality after myocardial infarction. The underlying role of socioeconomic status on increased mortality after MI deserves further investigation.

To identify higher-risk patients requiring special intensive care, and in whom new interventions can be performed to improve outcome, we recommend the preoperative calculation of creatinine clearance, especially in older women with a lower body mass index.