Post Myocardial Infarction by National Collaborating Centre for Primary Care

By National Collaborating Centre for Primary Care

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1 In patients after an MI there is conflicting evidence for an effect of vitamin E supplementation (alone or in combination with other anti-oxidants) on the risk of fatal and non-fatal MI with no consistent evidence of a benefit or harm (1++). 2 In patients after an MI, vitamin C supplementation does not appear to have any benefit (1++). 3 In patients after an MI, beta-carotene may increase cardiovascular deaths (1+). 4 In patients after an MI, advice to increase consumption of oily fish reduced allcause mortality (1+).

Participants in the control group received usual non-individualised care. The outcome measures were changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey, changes in diet self efficacy, and changes in health-related quality of life. At the end of the 6 week programme, there was a significant reduction in cholesterol-saturated fat index in both groups. However, there was no difference between the two groups. The percentage of energy obtained from carbohydrate increased significantly in both groups, although there was no difference between the treatment and control groups.

This was a population based prospective study of patients with cardiovascular disease aged 4059 years, selected from the age-sex registers of a single group general practice in each of 24 towns in England, Wales and Scotland. From the original 7735 men, 455 post MI patients and 200 angina patients were analyzed. Alcohol consumption was classified as follows: lifelong teetotallers (n= 43), ex-drinkers (n= 59), occasional drinkers (< 1 drink per month, n= 199) light drinkers (1-15 units per week, n= 230) moderate drinkers (16-42 units per week, n= 104), heavy drinkers (> 42 units per week, n= 20).

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