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CORonary Diet Intervention With Olive Oil and Cardiovascular PREVention

Not Applicable
Completed
Conditions
Unstable Angina
Cognitive Decline
Diabetes Mellitus
Metabolic Syndrome
Myocardial Infarction
Malignancy
Interventions
Behavioral: Low Fat Diet
Behavioral: Mediterranean Diet
Registration Number
NCT00924937
Lead Sponsor
Hospital Universitario Reina Sofia de Cordoba
Brief Summary

The purpose of this study is to compare the effects of the consumption of two different dietary patterns (low fat versus Mediterranean Diet) on the incidence of cardiovascular events of persons with coronary disease.

Detailed Description

Randomized clinical trial involving 1002 patients with coronary disease that are undergoing one of two diets in a randomized design (two groups; Mediterranean Diet 502 patients, Low Fat 500 patients) for 7 years. The two diets are: a)Low fat diet: \<30% fat (12-14% monounsaturated fatty acids (MUFA); 6-8% polyunsaturated fatty acid (PUFA) ; \<10% SAT) and b) Mediterranean Diet: \>35% fat (22% MUFA; 6% PUFA ; \<10% SAT).

Primary Objective:

Combined apparition of hard cardiovascular events (myocardial infarction, revascularization, ischemic stroke, documented peripheral artery disease or cardiovascular death).

Secondary Objectives:

Those related in the Outcome Measures section of this webpage

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1002
Inclusion Criteria
  • Informed Consent

  • Clinical: Unstable coronary disease with documented vessel/myocardial damage

    • Acute Myocardial Infarction
    • Revascularization
Exclusion Criteria
  • Age < 20 or > 75 years (or life expectancy lower than 5 years).

  • Patients already planned for revascularization.

  • Patients submitted to revascularization in the last 6 months

  • Grade II-IV Heart failure.

  • Left ventricle dysfunction with ejection fraction lower than 35%.

  • Patients unable to follow a protocol.

  • Patients with severe uncontrol of Diabetes Mellitus, or those with Renal Insufficiency with plasma creatinine higher than 2mg/dl, or cerebral complications of Diabetes mellitus.

  • Other chronic diseases:

    • Psychiatric diseases
    • Renal Insufficiency
    • Chronic Hepatopathy
    • Active Malignancy
    • Chronic obstructive pulmonary disease
    • Diseases of the digestive tract Endocrine disorders
  • Patients participating in other Clinical trials (in the enrollment moment or 30 days prior).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Low Fat DietLow Fat DietDietary Intervention with a Low fat diet: \<30% fat (12% monounsaturated fatty acids; 6-8%polyunsaturated fatty acids; \<10% saturated fatty acids)
Mediterranean DietMediterranean DietDietary Intervention with a Mediterranean Diet: 35-38% fat (22% monounsaturated fatty acids; 6% polyunsaturated fatty acids; \<10% saturated fatty acids).
Primary Outcome Measures
NameTimeMethod
Combined apparition of hard cardiovascular events (myocardial infarction, revascularization, ischemic stroke, documented peripheral artery disease or cardiovascular death) after a median follow-up of 7 years.Seven Years

Combined apparition of hard cardiovascular events (myocardial infarction, revascularization, ischemic stroke, documented peripheral artery disease or cardiovascular death) after a median follow-up of 7 years.

Secondary Outcome Measures
NameTimeMethod
Evolution of arteriosclerosis: Evaluation of arteriosclerosis at different vascular beds. Silent arteriosclerosis.Seven Years

Data from clinical and/or diagnostic tests will be analyzed

Concentration of LDL cholesterol.Seven Years

Concentration of LDL cholesterol in blood samples

Atherogenic ratio, and Total cholesterol/HDL and LDL/HDL.Seven Years

Comparison of Atherogenic ratio, and Total cholesterol/HDL and LDL/HDL during the study

Metabolic control of carbohydrates (assessed by glycemic and insulin responses to intravenous tolerance test to glucose, basal glycemia and hba1c).Seven Years

Study of the metabolism of carbohydrates during the trial

Blood pressure.Seven Years

Study of blood pressure in response to the study

Incidence of malignancy.Seven Years

Appearance of malignancy

Progression of Cognitive Decline.Seven Years

Cognitive decline will be evaluated by validated questionnaires

Extended composite of cardiovascular disease progressionSeven Years

Incidence of cardiac death, myocardial infarction, angina event, coronary revascularization or cardiac transplant, stroke, symptomatic heart failure, or any other clinical manifestation of cardiovascular event.

Extended composite of heart eventsSeven Years

Incidence of cardiac death , myocardial infarction , unstable angina , revascularization, heart failure, heart transplantation, cardiac arrest

Incidence of type 2 Diabetes MellitusUp to Seven Years

Incidence of type 2 Diabetes Mellitus during the study

Anthropometric changes. Metabolic diseaseUp to Seven Years

Clinical features of metabolic disease: Metabolic Syndrome, Metabolic Phenotypes of Obesity or other classifications based on anthropometric features will be assessed during the study

Gut MicrobiotaUp to Seven Years

Changes in the percentage of different families of Microbiota will be analyzed during the study, and their impact on clinical events.

ArrhythmiasUp to Seven Years

Study of relationship between existing or new Arrhythmias on clinical events

Individual evaluation of all components of the primary outcome.Up to Seven Years

Individual apparition of hard cardiovascular events:

* myocardial infarction

* revascularization

* ischemic stroke

* documented peripheral artery disease

* cardiovascular death

Global MetabolomicsUp to Seven Years

Global metabolomics in plasma, as well as techniques targeting specific sets of metabolites such as lipid-based lipid species, protein by proteomics, etc.

Inflammation and oxidative stressUp to Seven Years

Different physiological processes or metabolic pathways related to inflammation and oxidative stress will be studied

Specific metabolomicsUp to Seven Years

Specific metabolomics in plasma fractions, specific bioparticles such as lipoproteins or specific cells, lipidomics, proteomics, targeted metabolomics, etc

Gene ExpressionUp to Seven Years

Changes in Gene Expression using transcriptomic techniques such as gene expression microarrays, quantitative PCR, GeneChip, etc

AGEsUp to Seven Years

Metabolism of advanced glycation end products.

Mineral metabolismUp to Seven Years

Impact of mineral metabolism on atherosclerosis

Echographic markers of cardiac function and clinical outcomesUp to Seven Years

Cardiac function studies by Echocardiography at baseline and during the study

MicroparticlesUp to Seven Years

Study of endothelial microparticles (vesicles formed from endothelial cells membrane after injury). The quantification of the EPCs and EMPs will be performed by flow cytometry

Subgroup analysisUp to Seven Years

27. Differential impact on certain subgroups: Sex, age, anthropometry, genetics, genomics, metabolism of immediate principles, cardiovascular risk factors, cancer, vascular function

Trial Locations

Locations (1)

Reina Sofia University Hospital

🇪🇸

Cordoba, Spain

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