Most heart attacks occur in folks with pre-existing coronary artery disease that’s been present for years
If you already have coronary artery disease, Dr. Axel Sigurdsson says that ongoing saturated fat intake probably doesn’t matter, in terms of future cardiac events (like heart attacks) or risk of death from any cause.
Dr. Sigurdsson is a cardiologist in Iceland.
Some quotes from his blog:
For decades, cardiologists have advised patients with heart disease to restrict the intake of saturated fats and dietary cholesterol. Many patients still believe this to be the cornerstone of their lifestyle modification.
The main reason for avoiding saturated fats is the assumption that they adversely affect the lipid profile of our patients.
* * *
Recent studies suggest that the recommendation to avoid saturated fats may have been premature and not based on solid scientific evidence.
Now, a recently published Norwegian study shows that dietary intake of saturated fatty acids was not associated with risk of future events or death among patients with established coronary artery disease.
It is important to keep in mind that most of the patients were receiving secondary prevention drug therapy including aspirin, beta blockers and statins.
Anyhow, the results of the study certainly suggest that high intake of saturated fats is not a risk factor among patients with coronary heart disease receiving modern-day treatment.
These recent scientific data don’t imply hat we should urge our patients to consume high amounts of saturated fats. They only tell us that there is no association and accordingly, restriction won’t help.
So, it’s certainly a lifeline for those who believe red meat, whole-fat milk, cheese, cream, butter and eggs can be a part of a healthy diet.
On the other hand we must realise that scientific studies often provide contradictory results. A US study published last year suggested that greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality following acute heart attack.
It appears the jury is still out…
RTWT.
Paleo Diabetic 
That US study is an epidemiological study. In other words, it was not a randomized, controlled trial. As such, it’s basically useless.
BobM, I agree wholeheartedly that randomized controlled trials are better. But extremely difficult to do in free humans. Sometimes we have to take what we an get.