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Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction — A population-based prospective cohort study

  • Author Footnotes
    1 This author takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their specific contribution to the manuscript.
    Charlotte Bergkvist
    Footnotes
    1 This author takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their specific contribution to the manuscript.
    Affiliations
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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  • Marika Berglund
    Affiliations
    Unit of Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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  • Anders Glynn
    Affiliations
    Department of Risk and Benefit Assessment, National Food Agency, Box 622, SE-751 26 Uppsala, Sweden
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  • Alicja Wolk
    Affiliations
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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  • Author Footnotes
    1 This author takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their specific contribution to the manuscript.
    Agneta Åkesson
    Correspondence
    Corresponding author at: Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.
    Footnotes
    1 This author takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their specific contribution to the manuscript.
    Affiliations
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
    Search for articles by this author
  • Author Footnotes
    1 This author takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their specific contribution to the manuscript.
Published:January 27, 2015DOI:https://doi.org/10.1016/j.ijcard.2015.01.055

      Highlights

      • PCB exposure may mask the beneficial effect of fish consumption on CHD.
      • We examine dietary PCB exposure and incidence of myocardial infarction.
      • PCB was associated with 58% increased risk, comparing the highest exposure quartile with the lowest.
      • Intake of fish fatty acids may be associated with decreased risk.

      Abstract

      Background

      Fish consumption may promote cardiovascular health. The role of major food contaminants, such as polychlorinated biphenyls (PCBs) common in fatty fish, is unclear. We assessed the association between dietary PCB exposure and risk of myocardial infarction taking into account the intake of long-chain omega-3 fish fatty acids.

      Methods

      In the prospective population-based Swedish Mammography Cohort, 33,446 middle-aged and elderly women, free from cardiovascular disease, cancer and diabetes at baseline (1997) were followed-up for 12 years. Validated estimates of dietary PCB exposure and intake of fish fatty acids (eicosapentaenoic acid and docosahexaenoic acid; EPA-DHA) were obtained via a food frequency questionnaire at baseline.

      Results

      During follow-up 1386 incident cases of myocardial infarction were ascertained through register-linkage. Women in the highest quartile of dietary PCB exposure (median 286 ng/day) had a multivariable-adjusted RR of myocardial infarction of 1.21 (95% confidence interval [CI], 1.01–1.45) compared to the lowest quartile (median 101 ng/day) before, and 1.58 (95% CI, 1.10–2.25) after adjusting for EPA-DHA. Stratification by low and high EPA-DHA intake, resulted in RRs 2.20 (95% CI, 1.18–4.12) and 1.73 (95% CI, 0.81–3.69), respectively comparing highest PCB tertile with lowest. The intake of dietary EPA-DHA was inversely associated with risk of myocardial infarction after but not before adjusting for dietary PCB.

      Conclusion

      Exposure to PCBs was associated with increased risk of myocardial infarction, while some beneficial effect was associated with increasing EPA and DHA intake. To increase the net benefits of fish consumption, PCB contamination should be reduced to a minimum.

      Keywords

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