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Sweets Consumption is Associated with Higher 10-Year (2004-2014) Incidence of Cardiovascular Disease among Acute Coronary Syndrome Patients; The Detrimental Role of Socio-Economic Status: The GREECS (Greek of Acute Coronary Syndrome) Observational Study

Matina Kouvari, Venetia Notara, Demosthenes B. Panagiotakos, Moscho Michalopoulou, Eleni Kalli, Margarita Verdi, Nikos Vasileiou, Evangelos Papataxiarchis, Despoina Tzanoglou, Georgia Kouli, Yannis Mantas, Yannis Kogias, Petros Stravopodis, George Papanagnou, Spyros Zombolos and Christos Pitsavos

Objective: The aim of this work, and under the context of the GREECS study, was to evaluate the association between sweets consumption and the 10 year (2004-2014) incidence of Acute Coronary Syndrome (ACS), among cardiac patients. Methods: From October 2003 to September 2004, 2,172 ACS consecutive patients from 6 major Greek hospitals were enrolled; during 2013-2014, the 10-year follow-up was performed in 1,918 patients (88% participation rate); development of fatal or non-fatal ACS was the outcome of interest and recorded through medical records or registries. Among others, sweets (i.e., cakes, chocolate, traditional pastries, Lenten sweets, pies and other common Greek sweet treats) consumption at baseline examination was assessed using a semi-quantitative food frequency questionnaire. Results: A positive association was observed between sweets consumption (at least one portion per week vs. other) and ACS incidence after taking into account various potential confounders, including diabetes mellitus and obesity [OR=1.23, 95% CI (0.99, 1.53) p=0.060]. However, after stratified the analysis by education status (i.e., ≤ 9 vs. >9 years of school) the above association remained significant only among patients with higher educational status [OR=1.50, 95%CI (0.93, 2.40), p=0.095]; moreover, no significant interaction effect was observed between patients’ financial status and sweets consumption, on the tested outcome (p for interaction =0.56). Conclusion: Moderation or even avoidance of sweets consumption, in the context of healthier dietary habits, seems to be of high importance to reduce the risk of re-current cardiac events and improve disease prognosis among cardiac patients.