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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:726-732.)
© 1995 American Heart Association, Inc.

Articles

Association Between ß-Carotene and Acute Myocardial Infarction Depends on Polyunsaturated Fatty Acid Status

The EURAMIC Study

Alwine F.M. Kardinaal; Antti Aro; Jeremy D. Kark; Rudolph A. Riemersma; Pieter van 't Veer; Jorge Gomez-Aracena; Lenore Kohlmeier; Jetmund Ringstad; Blaise C. Martin; Vladimir P. Mazaev; Miguel Delgado-Rodriguez; Michael Thamm; Jussi K. Huttunen; José M. Martin-Moreno; Frans J. Kok

From the Department of Epidemiology (A.F.M.K., F.J.K., P. van 't V.), TNO Nutrition and Food Research, Zeist, and the Department of Epidemiology and Public Health (F.J.K.), Agricultural University, Wageningen, Netherlands; the Institute for Social Medicine and Epidemiology (L.K., M.T.), Federal Health Office, Berlin, Germany; the Department of Epidemiology and Statistics (J.M.M.-M.), Escuela Nacional de Sanidad, Madrid, Spain; the Medical Department (J.R.), Østfold Central Hospital, Fredrikstad, Norway; the Department of Preventive Medicine (J.G.-A.), University of Malaga, Spain; the Ministry of Health (V.P.M.), Research Center for Preventive Medicine, Moscow, Russia; the Institute of Social and Preventive Medicine (B.C.M.), University of Zurich, Switzerland; the Department of Nutrition (A.A., J.K.H.), National Public Health Institute, Helsinki, Finland; the Department of Social Medicine (J.D.K.), Hadassah Medical Organization and Hebrew University, Hadassah School of Public Health, Jerusalem, Israel; the Department of Preventive Medicine (M.D.-R.), University of Granada, Spain; and the Cardiovascular Research Unit (R.A.R.), University of Edinburgh, UK.

Correspondence to EURAMIC Coordinating Centre, TNO Nutrition and Food Research, Department of Epidemiology, PO Box 360, 3700 AJ Zeist, Netherlands.

Abstract Because antioxidants may play a role in the prevention of coronary heart disease by inhibiting the peroxidation of polyunsaturated fatty acids (PUFAs), the combined association of diet-derived antioxidants and PUFAs with acute myocardial infarction (MI) was investigated. This multicenter case-control study included 674 patients and 725 control subjects in eight European countries and Israel. Fatty acid composition and -tocopherol and ß-carotene levels were determined in adipose tissue; selenium level was determined in toenails. For -tocopherol no association with MI was observed at any PUFA level. The overall multivariate odds ratio (OR) for low (10th percentile) versus high (90th percentile) ß-carotene was 1.98 (95% confidence interval [CI], 1.39 to 2.82). The strength of this inverse association with MI was dependent on PUFA levels (in tertiles): for low PUFA, the OR for low versus high ß-carotene was 1.79 (95% CI, 0.98 to 3.25), for medium PUFA the OR was 1.76 (95% CI, 1.00 to 3.11), and for high PUFA 3.47 (95% CI, 1.93 to 6.24). For selenium increased risk was observed only at the lowest PUFA tertile (OR, 2.49; 95% CI, 1.22 to 5.09). This interaction between selenium and PUFAs was not significant and may at least partly be explained by a higher proportion of smokers at the low PUFA level. These findings support the hypothesis that ß-carotene plays a role in the protection of PUFAs against oxidation and subsequently in the protection against MI. No evidence was found that -tocopherol or selenium may protect against MI at any level of PUFA intake.

Key Words: antioxidants • ß-carotene • fatty acids • myocardial infarction • -tocopherol

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