TABLE 4.
ORs (95% CIs) of fatal and nonfatal AMI by quartile of the AHEI-2010 in Singapore Chinese Health Study participants1
| Quartile of AHEI-2010 score |
||||||
| 1 (lowest) | 2 | 3 | 4 (highest) | P-trend2 | AHEI-2010 score (per 10 points) | |
| Median score (IQR) | 42 (39–44) | 48 (47–49) | 53 (51–54) | 59 (57–62) | ||
| Overall | ||||||
| Cases/controls, n | 241/360 | 198/361 | 169/361 | 143/361 | 751/1443 | |
| Basic model3 | 1.0 (ref) | 0.83 (0.66, 1.06) | 0.71 (0.55, 0.90) | 0.59 (0.46, 0.76) | < 0.001 | 0.77 (0.68, 0.86) |
| Full model4 | 1.0 (ref) | 0.84 (0.66, 1.08) | 0.75 (0.58, 0.98) | 0.62 (0.47, 0.81) | < 0.001 | 0.79 (0.70, 0.90) |
| Full model + intermediates5 | 1.0 (ref) | 0.80 (0.61, 1.04) | 0.75 (0.57, 0.99) | 0.64 (0.48, 0.86) | 0.003 | 0.82 (0.72, 0.94) |
| Change,6 % | — | — | — | — | 15.5 | |
| Fatal AMI | ||||||
| Cases/controls, n | 98/142 | 78/128 | 57/143 | 55/138 | 288/551 | |
| Basic model3 | 1.0 (ref) | 0.91 (0.62, 1.33) | 0.59 (0.40, 0.88) | 0.59 (0.40, 0.89) | 0.003 | 0.78 (0.64, 0.94) |
| Full model4 | 1.0 (ref) | 0.94 (0.62, 1.43) | 0.60 (0.39, 0.93) | 0.60 (0.39, 0.94) | 0.009 | 0.78 (0.64, 0.96) |
| Full model + intermediates5 | 1.0 (ref) | 0.92 (0.59, 1.44) | 0.62 (0.39, 0.98) | 0.58 (0.36, 0.94) | 0.011 | 0.78 (0.63, 0.98) |
| Change,6 % | — | — | — | — | 0 | |
| Nonfatal AMI | ||||||
| Cases/controls, n | 182/279 | 146/271 | 132/268 | 104/265 | 564/1083 | |
| Basic model3 | 1.0 (ref) | 0.85 (0.64, 1.11) | 0.77 (0.58, 1.01) | 0.59 (0.44, 0.80) | 0.001 | 0.76 (0.66, 0.87) |
| Full model4 | 1.0 (ref) | 0.85 (0.64, 1.14) | 0.83 (0.61, 1.11) | 0.59 (0.43, 0.81) | 0.002 | 0.77 (0.66, 0.90) |
| Full model + intermediates5 | 1.0 (ref) | 0.79 (0.58, 1.07) | 0.83 (0.60, 1.13) | 0.64 (0.45, 0.90) | 0.016 | 0.81 (0.69, 0.95) |
| Change,6 % | — | — | — | — | 18.3 | |
AHEI, Alternative Healthy Eating Index; AMI, acute myocardial infarction; ref, reference.
Calculated by assigning the median value of the AHEI-2010 score in each quartile and modeling this as a continuous variable in models.
Covariates adjusted for through matching included age (±5 y) at biospecimen collection, sex (male or female), dialect group (Hokkien or Cantonese), year of interview (1993–1995 or 1996–1998), and year blood was collected. In addition, we adjusted for age at interview (y) and total energy intake (kcal/d).
In addition to the basic model, we adjusted for level of education (none, primary, or secondary and above), cigarette smoking (never; ex-smoker; current smoker: <13 or ≥13 cigarettes/d), physical activity (0 h/wk of moderate and strenuous activity, <4 h/wk of moderate or <2 h/wk of strenuous activity, ≥4 h/wk of moderate or ≥2 h/wk of strenuous activity), BMI (kg/m2; <18.5, 18.5 to <23, 23 to <27.5, or ≥27.5), history of diabetes (yes or no), and history of hypertension (yes or no).
In addition to the full model, we further adjusted for LDL and HDL cholesterol, TGs, high-sensitivity C-reactive protein, glycated hemoglobin, creatinine, and systolic blood pressure.
Percentage change in regression coefficients as a result of adjustment for potential intermediates.