Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .
Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione
Background —Our purpose was to assess the time course of the benefit of n-3 polyunsaturated fatty acids ( PUFAs ) on mortality documented by the GISSI-Prevenzione trial in patients surviving a recent ( <3 months ) myocardial infa rct ion . Methods and Results —In this study , 11 323 patients were r and omly assigned to supplements of n-3 PUFAs , vitamin E ( 300 mg/d ) , both , or no treatment ( control ) on top of optimal pharmacological treatment and lifestyle advice . Intention-to-treat analysis adjusted for interaction between treatments was carried out . Early efficacy of n-3 PUFA treatment for total , cardiovascular , cardiac , coronary , and sudden death ; nonfatal myocardial infa rct ion ; total coronary heart disease ; and cerebrovascular events was assessed by right-censoring follow-up data 12 times from the first month after r and omization up to 12 months . Survival curves for n-3 PUFA treatment diverged early after r and omization , and total mortality was significantly lowered after 3 months of treatment ( relative risk [ RR ] 0.59 ; 95 % CI 0.36 to 0.97;P = 0.037 ) . The reduction in risk of sudden death was specifically relevant and statistically significant already at 4 months ( RR 0.47 ; 95 % CI 0.219 to 0.995;P = 0.048 ) . A similarly significant , although delayed , pattern after 6 to 8 months of treatment was observed for cardiovascular , cardiac , and coronary deaths . Conclusions —The early effect of low-dose ( 1 g/d ) n-3 PUFAs on total mortality and sudden death supports the hypothesis of an antiarrhythmic effect of this drug . Such a result is consistent with the wealth of evidence coming from laboratory experiments on isolated myocytes , animal models , and epidemiological and clinical studies
Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .