My aunt had a mild heart attack last weekend and got back home Tuesday. The heart attack was stressed induced. The medication she is taking Plavix says she needs to stay away from foods with vitamin K in them f. Y. I. Broccoli, lettuce, cabbage, ect. Ect. So what she can she eat which is healthy for her but not going to put her back in the hospital? Any help would be very much appreciated. Thanks. I think I found an answer. I do not know where you obtained the information that for those taking clopidogrel (Plavix) that foods containing vitamin K – as you note above – are a concern. This is true if you are taking the anti-blood clot medication warfarin – which works on vitamin K clotting factors. Clopidogrel has an entirely different mode of action and specific foods do not interfere with its anti-blood clot properties. A mild heart attack generally implies a ‘small’ heart attack. These individuals typically have a good prognosis short term but may have an increased risk over the long term if they are not properly studied. Such study would require cardiac catherization to image the coronary arteries. Let me caution you however that physicians are typically not good communicators. Some physicians will refer to an episode as a ‘small heart attack’ when no true permanent heart damage is done. It was demonstrated by Marcus DeWood, M. D. In Spokane, Washington in 1981 that 87% of heart attacks are preceded by blood clots in the coronary arteries. This is why anti-blood clot medications are used. Clopidogrel is an expensive medication but it does not require the frequent monitoring that warfarin does. Warfarin has more potential drug interactions and diet does influence its effectiveness as noted above. When you ask what your aunt should eat – this is largely dependent upon her lipid profile. This typically includes total cholesterol, triglycerides (fats in the blood stream), LDL cholesterol (the ‘bad’ cholesterol), and HDL cholesterol (the ‘good’ cholesterol). I regard standard lipid profiles as rather simplistic at this point in time. LDL in lipid profiles for example is calculated by a 1972 formula developed by Dr. Friedewald. We now are able to easily and inexpensively measure LDL. In addition we have the ability to ‘fractionate’ LDL and HDL. Not all LDL is bad and not all HDL is good. Finally we have the ability to measure the number of ‘particles’ in LDL and HDL. All of this taken together allows the physician to precisely estimate a person’s risk of a second heart attack. If the lipid profile described above is carried out – and if it is normal – then your aunt is free to eat whatever she wishes. If there are abnormalities her physician will be able to help direct her diet. If you have additional questions please email me at johnerussomd@jhu. Edu. I wish you and your aunt the very best of health and may God Bless.