Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial

Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain

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Institut d′Investigació Pere Virgili (IISPV), 43204 Reus, Spain

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Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain

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Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain

¹⁰

Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain

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Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA

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Department of Preventive Medicine, Universidad de Valencia, 46100 Valencia, Spain

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Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain

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Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain

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Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain

¹⁶

Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain

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Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain

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Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain

¹⁹

Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain

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Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain

²¹

Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain

²²

Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain

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Both authors contributed equally to this work.

Nutrients 2020, 12(12), 3895; https://doi.org/10.3390/nu12123895

Received: 23 November 2020 / Revised: 12 December 2020 / Accepted: 16 December 2020 / Published: 19 December 2020

(This article belongs to the Section Nutritional Epidemiology)

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Abstract

Our aim is to assess whether following a Mediterranean Diet (MedDiet) decreases the risk of initiating antithrombotic therapies and the cardiovascular risk associated with its use in older individuals at high cardiovascular risk. We evaluate whether participants of the PREvención con DIeta MEDiterránea (PREDIMED) study allocated to a MedDiet enriched in extra-virgin olive oil or nuts (versus a low-fat control intervention) disclose differences in the risk of initiation of: (1) vitamin K epoxide reductase inhibitors (acenocumarol/warfarin; n = 6772); (2) acetylsalicylic acid as antiplatelet agent (n = 5662); and (3) other antiplatelet drugs (cilostazol/clopidogrel/dipyridamole/ditazol/ticlopidine/triflusal; n = 6768). We also assess whether MedDiet modifies the association between the antithrombotic drug baseline use and incident cardiovascular events. The MedDiet intervention enriched with extra-virgin olive oil decreased the risk of initiating the use of vitamin K epoxide reductase inhibitors relative to control diet (HR: 0.68 [0.46–0.998]). Their use was also more strongly associated with an increased risk of cardiovascular disease in participants not allocated to MedDiet interventions (HR_{control diet}: 4.22 [1.92–9.30], HR_MedDiets: 1.71 [0.83–3.52], p-interaction = 0.052). In conclusion, in an older population at high cardiovascular risk, following a MedDiet decreases the initiation of antithrombotic therapies and the risk of suffering major cardiovascular events among users of vitamin K epoxide reductase inhibitors. View Full-Text

Keywords: Mediterranean Diet; randomized controlled trials; prevention; 4-hydroxycoumarins; platelet aggregation inhibitors

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Castro-Barquero, S.; Ribó-Coll, M.; Lassale, C.; Tresserra-Rimbau, A.; Castañer, O.; Pintó, X.; Martínez-González, M.Á.; Sorlí, J.V.; Salas-Salvadó, J.; Lapetra, J.; Gómez-Gracia, E.; Alonso-Gómez, Á.M.; Fiol, M.; Serra-Majem, L.; Sacanella, E.; Basterra-Gortari, F.J.; Portolés, O.; Babio, N.; Cofán, M.; Ros, E.; Estruch, R.; Hernáez, Á. Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial. Nutrients 2020, 12, 3895. https://doi.org/10.3390/nu12123895

AMA Style

Castro-Barquero S, Ribó-Coll M, Lassale C, Tresserra-Rimbau A, Castañer O, Pintó X, Martínez-González MÁ, Sorlí JV, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Sacanella E, Basterra-Gortari FJ, Portolés O, Babio N, Cofán M, Ros E, Estruch R, Hernáez Á. Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial. Nutrients. 2020; 12(12):3895. https://doi.org/10.3390/nu12123895

Chicago/Turabian Style

Castro-Barquero, Sara, Margarita Ribó-Coll, Camille Lassale, Anna Tresserra-Rimbau, Olga Castañer, Xavier Pintó, Miguel Á. Martínez-González, José V. Sorlí, Jordi Salas-Salvadó, José Lapetra, Enrique Gómez-Gracia, Ángel M. Alonso-Gómez, Miquel Fiol, Lluis Serra-Majem, Emilio Sacanella, Francisco J. Basterra-Gortari, Olga Portolés, Nancy Babio, Montserrat Cofán, Emilio Ros, Ramón Estruch, and Álvaro Hernáez. 2020. "Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial" Nutrients 12, no. 12: 3895. https://doi.org/10.3390/nu12123895

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Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial

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