Miguel Á Martínez-González1, Estefanía Toledo1, Fernando Arós1, Miquel Fiol1, Dolores Corella1, Jordi Salas-Salvadó1, Emilio Ros1, Maria I Covas1, Joaquín Fernández-Crehuet1, José Lapetra1, Miguel A Muñoz1, Monserrat Fitó1, Luis Serra-Majem1, Xavier Pintó1, Rosa M Lamuela-Raventós1, Jose V Sorlí1, Nancy Babio1, Pilar Buil-Cosiales1, Valentina Ruiz-Gutierrez1, Ramón Estruch1, Alvaro Alonso1. 1. From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (M.A.M.-G., E.T., P.B.-C., A.A.); the PREDIMED (Prevención con Dieta Mediterránea) Research Network (M.A.M.-G., E.T., F.A., J.S.-S., J.F.-C., N.B., P.B.-C., V.R.-G., A.A.) and Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (M.A.M.-G., E.T., F.A., M. Fiol, D.C., J.S.-S., E.R., M.I.C., J.F.-C., J.L., M.A.M., M. Fitó, L.S.-M., X.P., R.M.L.-R., J.V.S., N.B., P.B.-C., V.R.-G., R.E., A.A.), Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.); Institute of Health Sciences, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain (M.Fiol); Department of Preventive Medicine, University of Valencia, Valencia, Spain (D.C., J.V.S.); Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry Biotechnology Department, Universitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPV, Reus, Spain (J.S.-S., N.B.); Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic (E.R., R.E.) and Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia dels Aliments, Instituto de Investigación en Nutrición y Seguridad Alimentaria (R.M.L.-R.), University of Barcelona, Barcelona, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, and Primary Care Division of Barcelona. Institut Català de la Salut and IDiap-Jordi Gol, Barcelona, Spain (M.I.C., M.A.M., M. Fitó); Department of Preventive Medicine, University of Malaga, Malaga, Spain (J.F.-C.); Department of Family Medicine, Primary Care Division of Seville, San Pablo Health Center, Seville, Spain (J.L.); Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain (L.S.-M.); Lipids and Vascular Risk Unit, Internal Medicine, Hospital
Abstract
BACKGROUND: The PREDIMED (Prevención con Dieta Mediterránea) randomized primary prevention trial showed that a Mediterranean diet enriched with either extravirgin olive oil or mixed nuts reduces the incidence of stroke, myocardial infarction, and cardiovascular mortality. We assessed the effect of these diets on the incidence of atrial fibrillation in the PREDIMED trial. METHODS AND RESULTS: Participants were randomly assigned to 1 of 3 diets: Mediterranean diet supplemented with extravirgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident atrial fibrillation was adjudicated during follow-up by an events committee blinded to dietary group allocation. Among 6705 participants without prevalent atrial fibrillation at randomization, we observed 72 new cases of atrial fibrillation in the Mediterranean diet with extravirgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group after median follow-up of 4.7 years. The Mediterranean diet with extravirgin olive oil significantly reduced the risk of atrial fibrillation (hazard ratio, 0.62; 95% confidence interval, 0.45-0.85 compared with the control group). No effect was found for the Mediterranean diet with nuts (hazard ratio, 0.89; 95% confidence interval, 0.65-1.20). CONCLUSIONS: In the absence of proven interventions for the primary prevention of atrial fibrillation, this post hoc analysis of the PREDIMED trial suggests that extravirgin olive oil in the context of a Mediterranean dietary pattern may reduce the risk of atrial fibrillation. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.
RCT Entities:
BACKGROUND: The PREDIMED (Prevención con Dieta Mediterránea) randomized primary prevention trial showed that a Mediterranean diet enriched with either extravirgin olive oil or mixed nuts reduces the incidence of stroke, myocardial infarction, and cardiovascular mortality. We assessed the effect of these diets on the incidence of atrial fibrillation in the PREDIMED trial. METHODS AND RESULTS:Participants were randomly assigned to 1 of 3 diets: Mediterranean diet supplemented with extravirgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident atrial fibrillation was adjudicated during follow-up by an events committee blinded to dietary group allocation. Among 6705 participants without prevalent atrial fibrillation at randomization, we observed 72 new cases of atrial fibrillation in the Mediterranean diet with extravirgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group after median follow-up of 4.7 years. The Mediterranean diet with extravirgin olive oil significantly reduced the risk of atrial fibrillation (hazard ratio, 0.62; 95% confidence interval, 0.45-0.85 compared with the control group). No effect was found for the Mediterranean diet with nuts (hazard ratio, 0.89; 95% confidence interval, 0.65-1.20). CONCLUSIONS: In the absence of proven interventions for the primary prevention of atrial fibrillation, this post hoc analysis of the PREDIMED trial suggests that extravirgin olive oil in the context of a Mediterranean dietary pattern may reduce the risk of atrial fibrillation. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.
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