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390 Does the Adherence to a Mediterranean Diet Influence Baseline and Postprandial Endothelial Function?
S245
Abstracts
respectively), TC (⫺13.6% and ⫺16.0%), TC/HDL-C ratio (⫺11.1% and ⫺12.9%), and triglycerides (⫺2.3% and ⫺4.2%). No significant changes in HDL-C were observed. After 26 weeks, 51.6% of the patients had LDL-C levels ⬍2.0 mmol/L using a dropout⫽failure approach. Compared to patients increasing their statin dose, a significantly greater proportion of patients adding a CAI achieved treatment target (60.8% vs. 50.1%; P⫽0.005). CONCLUSION: The results of this study show that adoption of a treat-to-target strategy is effective in inducing target LDL-C achievement in the majority of high CVD risk patients with persistent hyperlipidemia upon treatment with a statin. Statin dose optimization was the approach most commonly used by physicians followed by addition of a CAI or combination of both. Merck Canada
RESULTS: No correlations were found between global dietary score as assessed by the FFQ and postprandial endothelial response to either meal. The saturated fatty acid score (r ⫽ 0.40, p ⱕ 0.01) and ⍀-6/⍀-3 ratio (r ⫽ 0.35, p ⱕ 0.05) derived from the FFQ correlated positively with baseline endothelial function. Higher intake of PUFA ⍀-6 tended to impair postprandial endothelial response to a MMM but not to a HFM . CONCLUSION: Background dietary habits do not appear to influence postprandial endothelial response to a HFM and a MMM in a population of healthy men.
391 PREVALENCE OF RISK FACTORS AND OCCULT CORONARY DISEASE IN SOUTH ASIANS REFERRED TO A SPECIALIZED RISK ASSESSMENT CLINIC D Saha, M Tsigoulis, S Verma, N Singh, A Gupta, M Gupta
390 DOES THE ADHERENCE TO A MEDITERRANEAN DIET INFLUENCE BASELINE AND POSTPRANDIAL ENDOTHELIAL FUNCTION? J Cantin, S Lacroix, J Tardif, A Nigam Montréal, Québec BACKGROUND: Endothelial dysfunction is considered a precur-
sor of atherosclerosis and is an independent predictor of cardiovascular events. A high-saturated fat meal (HFM) has been shown to induce postprandial endothelial dysfunction. Adherence to the Mediterranean diet has been linked to improved endothelial function and was associated to lower inflammatory profile. Recently, we found that a single mixed Mediterraneantype meal (MMM) had neutral postprandial endothelial impact. To our knowledge, the influence of dietary habits on postprandial endothelial response has yet to be determined. OBJECTIVE: This substudy sought to assess the influence of background dietary habits on postprandial endothelial response to both HFM and MMM. METHOD: This is a substudy of the FATT trial that compared the effect of a HFM and a MMM on postprandial endothelial function in 28 healthy non-smoking males aged between 18 and 50 years. The MMM consisted of fresh salmon, almonds and vegetables baked in olive oil providing 51% of total calories from fat (7.87g SFA and 2.29g of omega-3, 2:1 DHA:EPA). The HFM consisted of a McDonald’s sausage, egg and cheese McMuffin and three hashbrowns providing 58% of total energy from fat (14.78g SFA and no omega-3). Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD) after a 12-hour fast (T0) and at two (T2) and four (T4) hours after consumption of the test meals. Dietary assessment: A 14-item semi-quantitative food frequency questionnaire (FFQ) was used to assess dietary habits. This FFQ was developed to provide a global dietary score reflecting coronary heart disease risk, an estimated ⍀-6/⍀-3 ratio and scores of intake for saturated fatty acids, monounsaturated fatty acids, ⍀-3 polyunsaturated fatty acids and fruits and vegetables.
Brampton, Ontario BACKGROUND: South Asians (SA) are at increased risk for prema-
ture coronary heart disease (CHD) compared to white Caucasians. A specialized risk assessment clinic was established to facilitate screening and detection of risk factors, and implementation of evidence-based risk reduction strategies in SA without prior CHD. The first 483 patients are characterized below. METHODS: Between June 2010 and April 2012, 483 subjects were referred to the SA Risk Assessment Clinic in Brampton, ON. Inclusion criteria for referral included SA ethnicity, men ⬎30y or women ⬎40y, absence of known CHD or cardiac symptoms, and presence of one or more CV risk factors. Patients were evaluated by specialists expert in ethnic-specific risk assessment using validated tools (Framingham (FRS) and ETHRISK scores). RESULTS: The mean age was 55.3y (⫹/⫺12.0), and 68.7% were male. Subjects had been living in Canada on average for 18 years. One third (32.3%) were vegetarian, 65.8% exercised fewer than 4 days/week, and 66% considered themselves overweight. Additional risk factor summaries are shown in Table 1 below. At baseline assessment, LDL-cholesterol was at target in 100% of low risk patients (by Framingham Risk Score), 62.9% of intermediate risk and 50.5% of high risk patients. Based upon abnormal non-invasive test results or elicited symptoms, coronary angiography was performed in 50 patients, of whom 35 were found to have CHD. Fourteen of these patients required PCI (8) or CABG (6). At baseline assessment, 37.5% of the patients with moderate to severe CHD had a low or intermediate FRS. CONCLUSIONS: South Asians referred to a specialized clinic for primary prevention of CVD have a high prevalence of abdominal obesity, hypertension, hyperlipidemia, diabetes and metabolic syndrome, and tend to be sedentary. A substantial proportion (43.9 %) of these patients, both men and women, had a high FRS. Suboptimal control was observed for BP, particularly in patients with diabetes, and LDL-c in the higher FRS groups. Importantly, underlying CHD was identified in 7.2% of subjects, including those with low or intermediate FRS and coronary revascularization was required in 14 subjects. Thus,
Abstracts
respectively), TC (⫺13.6% and ⫺16.0%), TC/HDL-C ratio (⫺11.1% and ⫺12.9%), and triglycerides (⫺2.3% and ⫺4.2%). No significant changes in HDL-C were observed. After 26 weeks, 51.6% of the patients had LDL-C levels ⬍2.0 mmol/L using a dropout⫽failure approach. Compared to patients increasing their statin dose, a significantly greater proportion of patients adding a CAI achieved treatment target (60.8% vs. 50.1%; P⫽0.005). CONCLUSION: The results of this study show that adoption of a treat-to-target strategy is effective in inducing target LDL-C achievement in the majority of high CVD risk patients with persistent hyperlipidemia upon treatment with a statin. Statin dose optimization was the approach most commonly used by physicians followed by addition of a CAI or combination of both. Merck Canada
RESULTS: No correlations were found between global dietary score as assessed by the FFQ and postprandial endothelial response to either meal. The saturated fatty acid score (r ⫽ 0.40, p ⱕ 0.01) and ⍀-6/⍀-3 ratio (r ⫽ 0.35, p ⱕ 0.05) derived from the FFQ correlated positively with baseline endothelial function. Higher intake of PUFA ⍀-6 tended to impair postprandial endothelial response to a MMM but not to a HFM . CONCLUSION: Background dietary habits do not appear to influence postprandial endothelial response to a HFM and a MMM in a population of healthy men.
391 PREVALENCE OF RISK FACTORS AND OCCULT CORONARY DISEASE IN SOUTH ASIANS REFERRED TO A SPECIALIZED RISK ASSESSMENT CLINIC D Saha, M Tsigoulis, S Verma, N Singh, A Gupta, M Gupta
390 DOES THE ADHERENCE TO A MEDITERRANEAN DIET INFLUENCE BASELINE AND POSTPRANDIAL ENDOTHELIAL FUNCTION? J Cantin, S Lacroix, J Tardif, A Nigam Montréal, Québec BACKGROUND: Endothelial dysfunction is considered a precur-
sor of atherosclerosis and is an independent predictor of cardiovascular events. A high-saturated fat meal (HFM) has been shown to induce postprandial endothelial dysfunction. Adherence to the Mediterranean diet has been linked to improved endothelial function and was associated to lower inflammatory profile. Recently, we found that a single mixed Mediterraneantype meal (MMM) had neutral postprandial endothelial impact. To our knowledge, the influence of dietary habits on postprandial endothelial response has yet to be determined. OBJECTIVE: This substudy sought to assess the influence of background dietary habits on postprandial endothelial response to both HFM and MMM. METHOD: This is a substudy of the FATT trial that compared the effect of a HFM and a MMM on postprandial endothelial function in 28 healthy non-smoking males aged between 18 and 50 years. The MMM consisted of fresh salmon, almonds and vegetables baked in olive oil providing 51% of total calories from fat (7.87g SFA and 2.29g of omega-3, 2:1 DHA:EPA). The HFM consisted of a McDonald’s sausage, egg and cheese McMuffin and three hashbrowns providing 58% of total energy from fat (14.78g SFA and no omega-3). Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD) after a 12-hour fast (T0) and at two (T2) and four (T4) hours after consumption of the test meals. Dietary assessment: A 14-item semi-quantitative food frequency questionnaire (FFQ) was used to assess dietary habits. This FFQ was developed to provide a global dietary score reflecting coronary heart disease risk, an estimated ⍀-6/⍀-3 ratio and scores of intake for saturated fatty acids, monounsaturated fatty acids, ⍀-3 polyunsaturated fatty acids and fruits and vegetables.
Brampton, Ontario BACKGROUND: South Asians (SA) are at increased risk for prema-
ture coronary heart disease (CHD) compared to white Caucasians. A specialized risk assessment clinic was established to facilitate screening and detection of risk factors, and implementation of evidence-based risk reduction strategies in SA without prior CHD. The first 483 patients are characterized below. METHODS: Between June 2010 and April 2012, 483 subjects were referred to the SA Risk Assessment Clinic in Brampton, ON. Inclusion criteria for referral included SA ethnicity, men ⬎30y or women ⬎40y, absence of known CHD or cardiac symptoms, and presence of one or more CV risk factors. Patients were evaluated by specialists expert in ethnic-specific risk assessment using validated tools (Framingham (FRS) and ETHRISK scores). RESULTS: The mean age was 55.3y (⫹/⫺12.0), and 68.7% were male. Subjects had been living in Canada on average for 18 years. One third (32.3%) were vegetarian, 65.8% exercised fewer than 4 days/week, and 66% considered themselves overweight. Additional risk factor summaries are shown in Table 1 below. At baseline assessment, LDL-cholesterol was at target in 100% of low risk patients (by Framingham Risk Score), 62.9% of intermediate risk and 50.5% of high risk patients. Based upon abnormal non-invasive test results or elicited symptoms, coronary angiography was performed in 50 patients, of whom 35 were found to have CHD. Fourteen of these patients required PCI (8) or CABG (6). At baseline assessment, 37.5% of the patients with moderate to severe CHD had a low or intermediate FRS. CONCLUSIONS: South Asians referred to a specialized clinic for primary prevention of CVD have a high prevalence of abdominal obesity, hypertension, hyperlipidemia, diabetes and metabolic syndrome, and tend to be sedentary. A substantial proportion (43.9 %) of these patients, both men and women, had a high FRS. Suboptimal control was observed for BP, particularly in patients with diabetes, and LDL-c in the higher FRS groups. Importantly, underlying CHD was identified in 7.2% of subjects, including those with low or intermediate FRS and coronary revascularization was required in 14 subjects. Thus,