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Aims. We evaluated the interaction effect between depressive symptoms and dietary habits on 30-day development of cardiovascular disease (CVD) (death or rehospitalization) in elderly, acute coronary syndrome (ACS) survivors. Methods.  During 2006–2008, we recorded 277 nonfatal, consecutive ACS admissions (75 ± 6 years, 70% males, 70% had diagnosis of myocardial infarction)  with complete 30-day follow-up. Assessment of recent depressive symptoms was based on the CES-D scale. Among sociodemographic, bioclinical, lifestyle characteristics, the MedDietScore that assesses the inherent characteristics of the Mediterranean diet was applied. Results.  22%  of the ACS pts developed a CVD event during the first 30 days (14.8%  rehospitalization and 9.4% death). Patients in the upper tertile of the CES-D scale (i.e., 	>18)  had higher incidence of CVD events as compared with those in the lowest tertile (21% versus 8%, =.01).  Multiple logistic regression analysis revealed that 1-unit increase in CES-D was associated with 4% higher odds (95%  CI 1.008–1.076, =.01)  of CVD events; however, when MedDietScore was entered in the model, CES-D lost its significance (=.20). Conclusion. Short-term depressive symptoms are related to a worsen 30-day prognosis of ACS patients; however, this relationship was mediated by Mediterranean diet adherence

Mediterranean Diet Mediates the Adverse Effect of Depressive Symptomatology on Short-Term Outcome in Elderly Survivors from an Acute Coronary Event