Role of Cardioprotective Diet in Acute Coronary Syndrome

Problem statement: Nutritional factors appear to be quite important in the pathogenesis and prognosis among patients of Acute Myocardial Infarction (AMI) or Acute Coronary Syndrome (ACS). Increased consumption of proinflammatory foods; such as refined starches and sugar, trans fat, saturated fat and w-6 fatty acids may increase proi nflammatory cytokines, oxidative stress and free fatty acids causing endothelial dysfunction. Approach: Columbus foods with low w-6/w-3 ratio of fatty acids, may play a protective role. Many adver se parameters such as higher concentrations of proinflammatory cytokines, transcription factors an d adhesion molecules, free radicals and decrease in nitrite levels were shown to be related to the diet ary composition and thus may serve as independent predictors of ACS. Diets rich in w-3 fatty acids, v itamins, minerals and antioxidants and low in refin ed carbohydrates cause decrease in levels of plasma li pid peroxides, antioxidant vitamins, serum Glutamic Oxaloacetate Transaminase (SGOT) and Lactate Dehydrogenase (LDH) cardiac enzymes in patients with ACS. Results: Available evidence indicate that cardioprotective d iet can decrease sudden cardiac deaths, total cardiac deaths, non-fatal inf ractions and total cardiac events among patients receiving such diet compared to standard diet. The existing evidence support that diet rich in w-3 fat ty acids, vitamins, minerals and antioxidants with low refined carbohydrates may be beneficial to vascula r endothelium and myocardium and thus seems to function as cardioprotective in patients with ACS. Conclusion: The Western foods that lack essential vitamins, mi nerals and w-3 fatty acids and that are rapidly absorbed should be avoided in patients with ACS. More studies especially in the context of developing countries are required for establishing the vital role of the cardio protective diet.