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Association between beta-carotene and acute myocardial infarction depends on polyunsaturated fatty acid status : the EURAMIC study

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Author: Kardinaal, A.F.M. · Aro, A. · Kark, J.D. · Riemersma, R.A. · Veer, P. van 't · Gomez-Aracena, J. · Kohlmeier, L. · Ringstad, J. · Martin, B.C. · Mazaev, V.P. · Delgado-Rodriguez, M. · Thamm, M. · Huttunen, J.K. · Martin-Moreno, J.M. · Kok, F.J.
Institution: Centraal Instituut voor Voedingsonderzoek TNO
Source:Arteriosclerosis, Thrombosis, and Vascular Biology, 6, 15, 726-732
Identifier: 82430
Keywords: Biology · Adipose Tissue · Antioxidants · beta Carotene · Carotenoids · Case-Control Studies · Coronary Disease · Fatty Acids, Unsaturated · Humans · Male · Middle Aged · Multivariate Analysis · Myocardial Infarction · Nails · Risk Factors · Selenium · Smoking · Toes


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 α-tocopherol and β-carotene levels were determined in adipose tissue; selenium level was determined in toenails. For α-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) β-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 β-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 β-carotene plays a role in the protection of PUFAs against oxidation and subsequently in the protection against MI. No evidence was found that α-tocopherol or selenium may protect against MI at any level of PUFA intake.