Comparison of Low-Fat Versus Mediterranean-Style Dietary Intervention After First Myocardial Infarction (from The Heart Institute of Spokane Diet Intervention and Evaluation Trial)^†

Flow diagram for patients with first MIs in the randomized portion of THIS-DIET.

Kaplan-Meier survival curves after first MI representing the percentage free of the primary outcome, a composite of first events including all-cause and cardiac deaths, MI, hospital admissions for heart failure, unstable angina, or stroke. Active comparison of dietary intervention with a low-fat diet (red line) versus a Mediterranean-style diet (blue line) in the randomized portion of THIS-DIET (log-rank p = 0.81).

Kaplan-Meier survival curves after first MI representing the percentage free of the primary outcome, a composite of first events including all-cause and cardiac deaths, MI, hospital admissions for heart failure, unstable angina, or stroke. Prospective case-control analysis of combined dietary intervention patients (purple line) versus usual-care controls (green line) (log-rank p <0.001). The unadjusted odds ratio for the primary outcome was 0.33 (95% confidence interval 0.18 to 0.60, p <0.001) for dietary intervention compared with usual care. The adjusted odds ratio was 0.28 (95% confidence interval 0.13 to 0.63, p = 0.002) after controlling for baseline frequencies of obesity, smoking, and cardiac rehabilitation enrollment; low-density lipoprotein cholesterol level; and discharge medicine use (Table 2).