Impact of MEditerranean Diet, Inflammation and Microbiome on plaque vulnerability and microvascular dysfunction after an Acute Coronary Syndrome. A randomized, controlled, mechanistic clinical trial

Coronary atherosclerosis is a leading cause of mortality and disability worldwide. Continuous efforts are needed to improve secondary prevention and understand the mechanism underlying disease progression. Based on primary prevention trials, a potential benefit of the Mediterranean diet after an acute coronary syndrome can be anticipated. The integrated microbiome-mediated/immunologic and metabolic pathways by which the Mediterranean diet modifies cardiovascular risk remain mostly unknown. Intestinal and oral dysbiosis is involved in the pathogenesis of atherosclerosis and microbiome dynamics may account for some of the observed benefits of Mediterranean diet.Our first objective is to evaluate the effects of a well-controlled Mediterranean diet intervention on atherosclerotic plaque vulnerability and coronary endothelial dysfunction after an episode of acute coronary syndrome. The second objective is to decipher the interplays among diet, microbiota, immunity and metabolism responsible for the observed effects. We propose a randomized mechanistic clinical trial, using state-of-the-art efficacy read-outs. The multidisciplinary consortium includes highly experienced cardiologists, nutritionists and experts in translational research in immunology, microbiomics, genomics, proteomics, metabolomics and metagenomics. This study will provide valuable insights to identify potential microbiome therapeutic targets for coronary artery disease.


Partner Organization Partner Country
Université Paris-Diderot France
Tel Aviv University Israel
University of Gothenburg Sweden



  • The current proposal consists of original research on a diet intervention for secondary prevention in patients who have suffered acute coronary syndrome. This study will provide valuable insights to identify potential microbiome therapeutic targets for coronary artery disease.Clinical data registration, sampling and analysis are in course. Initial data will be able by June 2021. The study will be completed by May 2022.


Title: The impact of Mediterranean diet on coronary plaque vulnerability, microvascular function, inflammation and microbiome after an acute coronary syndrome: study protocol for the MEDIMACS randomized, controlled, mechanistic clinical trial
Author: Ana I Fernández,a Javier Bermejo,a* Raquel Yotti,a Miguel Ángel Martínez-Gonzalez,b Alex Mira,c Uri Gophna,d Roger Karlsson,e Reem Al-Daccak,f Irene Martín-Demiguel,a Enrique Gutiérrez-Ibanes,a Dominique Charron,f and Francisco Fernández-Avilésa On behalf of the MEDIMACS researcher team

Communication & Dissemination Activities

Target groupAuthors
Medical doctorsAna Isabel Fernández. Francisco Fernandez-Avilés, Javier Bermejo. Presentación del ensayo MEDIMACS. Hospital Geenral Univeresitario Gregorio Marañón. Madrid. Spain.2018-2019
Cardiologists and researchers in cardiologyIrene Mendez, Ana I Fernandez, Javier Bermejo, Francisco Fernández-Aviles. Rehabilitación cardiaca-MEDIMACS. Congreso Nacional de Enfermedades Cardiológicas. Barcelona. Spain. 2019
ResearchersJavier Bermejo, Ana I Fernández, Francisco Fernández-Avilés. MEDIMACS: dieta, microbiota y aterosclerosis. Reunión Anual CIBERCV. Madrid. Spain. 2019


Project number:
Duration: 100%
Duration: 100 %
Project lead and secretary:
Francisco Fernández-Avilés