Table 3.
Subdistribution hazard ratios and 95% confidence intervals for quartiles of baseline diet quality on primary CVD events after breast cancer diagnosisa,b
| Diet quality indices | Ischemic heart disease (n = 3240) |
Heart failure (n = 3327) |
Cardiomyopathy (n = 3377) |
Stroke and/or transient ischemic attack (n = 3370) |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Events | Person-time, y | HR (95% CI) | P trend | Events | Person-time, y | HR (95% CI) | P trend | Events | Person-time, y | HR (95% CI) | P trend | Events | Person-time, y | HR (95% CI) | P trend | |
| Dietary Approaches to Stop Hypertension | .96 | .03 | .27 | .27 | ||||||||||||
| Q1 | 36 | 7931 | Referent | 52 | 8189 | Referent | 19 | 8396 | Referent | 29 | 8396 | Referent | ||||
| Q2 | 51 | 11 381 | 1.06 (0.68 to 1.64) | 68 | 11 806 | 0.88 (0.61 to 1.29) | 18 | 12 020 | 0.81 (0.41 to 1.58) | 35 | 11 991 | 0.82 (0.49 to 1.37) | ||||
| Q3 | 32 | 7985 | 1.02 (0.61 to 1.72) | 46 | 8191 | 0.81 (0.53 to 1.24) | 10 | 8341 | 0.68 (0.30 to 1.56) | 22 | 8363 | 0.61 (0.34 to 1.10) | ||||
| Q4 | 31 | 9033 | 0.95 (0.56 to 1.60) | 33 | 9308 | 0.53 (0.33 to 0.87) | 6 | 9574 | 0.41 (0.15 to 1.10) | 27 | 9457 | 0.74 (0.43 to 1.27) | ||||
| Healthy plant-based dietary index | .44 | .02 | .61 | .55 | ||||||||||||
| Q1 | 36 | 8666 | Referent | 59 | 8910 | Referent | 18 | 9090 | Referent | 27 | 9118 | Referent | ||||
| Q2 | 44 | 9999 | 1.36 (0.85 to 2.17) | 51 | 10 307 | 0.80 (0.53 to 1.20) | 15 | 10 498 | 0.90 (0.45 to 1.81) | 38 | 10 475 | 1.18 (0.69 to 2.02) | ||||
| Q3 | 29 | 8492 | 0.97 (0.59 to 1.61) | 49 | 8730 | 0.85 (0.57 to 1.28) | 8 | 8974 | 0.51 (0.21 to 1.23) | 25 | 8924 | 1.04 (0.56 to 1.92) | ||||
| Q4 | 41 | 9172 | 1.44 (0.89 to 2.35) | 40 | 9546 | 0.60 (0.39 to 0.94) | 12 | 9769 | 0.89 (0.38 to 2.09) | 23 | 9689 | 0.84 (0.46 to 1.53) | ||||
| 2020 Healthy Eating Index | .27 | .29 | .67 | .98 | ||||||||||||
| Q1 | 34 | 8644 | Referent | 47 | 8939 | Referent | 16 | 9178 | Referent | 31 | 9094 | Referent | ||||
| Q2 | 36 | 9265 | 1.09 (0.67 to 1.75) | 64 | 9435 | 1.32 (0.89 to 1.97) | 15 | 9636 | 0.89 (0.43 to 1.86) | 25 | 9685 | 0.80 (0.46 to 1.37) | ||||
| Q3 | 41 | 9769 | 1.30 (0.80 to 2.09) | 46 | 10 169 | 0.90 (0.58 to 1.37) | 12 | 10 321 | 0.83 (0.36 to 1.92) | 22 | 10 348 | 0.64 (0.36 to 1.12) | ||||
| Q4 | 39 | 8651 | 1.42 (0.87 to 2.33) | 42 | 8950 | 0.84 (0.53 to 1.33) | 10 | 9196 | 0.87 (0.37 to 2.05) | 35 | 9080 | 1.07 (0.65 to 1.77) | ||||
| American Cancer Society nutrition guidelines for cancer prevention | .29 | .74 | .29 | .29 | ||||||||||||
| Q1 | 35 | 9194 | Referent | 49 | 9471 | Referent | 20 | 9637 | Referent | 34 | 9570 | Referent | ||||
| Q2 | 43 | 9436 | 1.25 (0.79 to 1.99) | 48 | 9771 | 1.00 (0.66 to 1.52) | 14 | 9979 | 0.77 (0.37 to 1.59) | 27 | 10 032 | 0.66 (0.39 to 1.14) | ||||
| Q3 | 34 | 8805 | 1.08 (0.66 to 1.77) | 59 | 9053 | 1.24 (0.84 to 1.84) | 13 | 9270 | 0.80 (0.39 to 1.66) | 27 | 9275 | 0.74 (0.43 to 1.25) | ||||
| Q4 | 38 | 8894 | 1.35 (0.83 to 2.20) | 43 | 9198 | 1.02 (0.66 to 1.58) | 6 | 9446 | 0.41 (0.15 to 1.09) | 25 | 9329 | 0.70 (0.41 to 1.21) | ||||
| Alternate Mediterranean dietary index | .53 | .13 | .12 | .77 | ||||||||||||
| Q1 | 32 | 8174 | Referent | 51 | 8524 | Referent | 17 | 8742 | Referent | 33 | 8612 | Referent | ||||
| Q2 | 26 | 6405 | 1.21 (0.70 to 2.09) | 44 | 6607 | 1.12 (0.73 to 1.73) | 12 | 6720 | 1.06 (0.48 to 2.32) | 21 | 6744 | 0.78 (0.43 to 1.40) | ||||
| Q3 | 59 | 12 877 | 1.41 (0.87 to 2.29) | 76 | 13 230 | 1.21 (0.82 to 1.80) | 18 | 13 602 | 0.85 (0.41 to 1.75) | 33 | 13 634 | 0.68 (0.40 to 1.16) | ||||
| Q4 | 33 | 8873 | 1.27 (0.71 to 2.26) | 28 | 9133 | 0.68 (0.39 to 1.19) | 6 | 9268 | 0.55 (0.18 to 1.66) | 26 | 9217 | 0.89 (0.51 to 1.56) | ||||
a
Adjusted for age at diagnosis, race and ethnicity, education level, menopausal status, physical activity, smoking status, energy intake, alcohol intake, health plan utilization, comorbidities, cancer stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, cardiometabolic conditions, and any nonoutcome CVD event prior to breast cancer diagnosis. CI = confidence interval; CVD = cardiovascular disease; HR = hazard ratio; Q = quartile.
b
Participants with CVD outcome of interest prior to breast cancer diagnosis were excluded.