CORonary Diet Intervention with Olive oil and cardiovascular PREVention study - CORDIOPREV

Contribution To Literature:

The CORDIOPREV trial showed that a Mediterranean diet was successful at preventing major adverse cardiovascular events.


The goal of the trial was to evaluate a Mediterranean diet compared with a low-fat diet among patients with established coronary heart disease.

Study Design

  • Randomization
  • Parallel

Patients with coronary heart disease were randomized to a Mediterranean diet (n = 502) versus a low-fat diet (n = 500). Participants in the Mediterranean group received one liter of extra virgin olive oil per week, with instructions to use one tablespoon of olive oil per day. Participants in the low-fat diet group received healthy food bag packs rich in complex carbohydrates, with instructions to use <2 tablespoons of vegetable oil per day.

  • Total number of enrollees: 1,002
  • Duration of follow-up: 7 years
  • Mean patient age: 59.5 years
  • Percentage female: 18%
  • Percentage with diabetes: 54%

Inclusion criteria:

  • Patients 20-75 years of age
  • Established coronary heart disease (acute myocardial infarction, hospitalization for unstable angina, or chronic high-risk ischemic heart disease)

Exclusion criteria:

  • Severe heart failure (New York Heart Association functional class III or IV)
  • Severe left ventricular systolic dysfunction (with ejection fraction ≤35%)
  • Risk factors that are severe or difficult to control
  • Chronic diseases unrelated to coronary risk

Principal Findings:

The primary outcome, myocardial infarction, revascularization, ischemic stroke, peripheral artery disease, or cardiovascular death, occurred at a crude rate of 28.1 events per person-years in the Mediterranean diet group versus 37.7 events per person-years in the low-fat diet group (p = 0.039).


Among patients with established coronary heart disease, a Mediterranean diet versus a low-fat diet was successful at preventing major adverse cardiovascular events. The event curves appear to separate after approximately 3 years. Important differences from this study and the Lyon Diet Heart Study are that the latter used canola oil and the comparator was a prudent Western-type diet.


Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomized controlled trial. Lancet 2022;May 4:[Epub ahead of print].

Clinical Topics: Cardiac Surgery, Diabetes and Cardiometabolic Disease, Dyslipidemia, Invasive Cardiovascular Angiography and Intervention, Prevention, Vascular Medicine, Atherosclerotic Disease (CAD/PAD), Cardiac Surgery and Arrhythmias, Lipid Metabolism, Interventions and Vascular Medicine, Diet

Keywords: Angina, Unstable, Brain Ischemia, Carbohydrates, Coronary Disease, Diabetes Mellitus, Diet, Fat-Restricted, Diet, Mediterranean, Dyslipidemias, Ischemic Stroke, Metabolic Syndrome, Myocardial Infarction, Myocardial Ischemia, Myocardial Revascularization, Olive Oil, Peripheral Arterial Disease, Plant Oils, Risk Factors, Secondary Prevention, Stroke, Vascular Diseases

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