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ORIGINAL RESEARCH COMMUNICATION |
1 From the Cardiovascular Nutrition Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston (ATE and AHL); the Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland (ATE); the Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and the Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston (DM); and the Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC (DMH)
Background: Higher intakes of fish and n–3 fatty acids are associated with a reduced risk of cardiovascular events and mortality. However, limited data exist on the effect of fish intake on actual measures of progression of coronary artery atherosclerosis.
Objective: The aim was to examine the association between fish intake and the progression of coronary artery atherosclerosis in women with coronary artery disease.
Design: This was a prospective cohort study of postmenopausal women (n = 229) participating in the Estrogen Replacement and Atherosclerosis trial. Usual fish intake was estimated at baseline with a food-frequency questionnaire. Quantitative coronary angiography was performed at baseline and after 3.2 ± 0.6 (
± SD) y to evaluate changes in the mean minimum coronary artery diameter, the mean percentage of stenosis, and the development of new coronary lesions.
Results: Compared with lower fish intakes, consumption of 
2 servings of fish or 1 serving of tuna or dark fish per week was associated with smaller increases in the percentage of stenosis (4.54 ± 1.37% compared with –0.06 ± 1.59% and 5.12 ± 1.48% compared with 0.35 ± 1.47%, respectively; P < 0.05 for both) in diabetic women after adjustments for age, cardiovascular disease risk factors, and dietary intakes of fatty acids, cholesterol, fiber, and alcohol. These associations were not significant in nondiabetic women. Higher fish consumption was also associated with smaller decreases in minimum coronary artery diameter and fewer new lesions.
Conclusions: Consumption of fish is associated with a significantly reduced progression of coronary artery atherosclerosis in women with coronary artery disease.
Key Words: Fish • atherosclerosis • angiography • women • diet • n–3 fatty acids • diabetes mellitus
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