Abstract 11256: Plasma Eicosapentaenoic Acid/Arachidonic Acid Ratio Predicts Late In-stent Restenosis After Bare Metal Stenting in Patients With Acute Myocardial Infarction
Background: In-stent restenosis (ISR) is still one of the major limitations of percutaneous coronary intervention (PCI). Omega-3 fatty acids in fish oils have been reported to have significant antithrombotic and anti-atherosclerotic effects, suggesting the potential to prevent in-stent restenosis. This study evaluated the relation between the plasma eicosapentaenoic acid/arachidonic acid (EPA/AA) ratio and ISR at 8 months after primary PCI with bare metal stents for acute myocardial infarction (AMI).
Methods: We enrolled 92 consecutive AMI patients who underwent successful PCI with bare metal stents for de novo lesions in native coronary arteries and had follow-up angiography after 8 months. Plasma levels of EPA and AA were measured before PCI.
Results: Angiographic ISR (defined as >50% diameter stenosis) was detected in 26 (28%) patients at 8 months. The patients with restenosis had a significantly lower EPA/AA ratio than those without ISR (0.35±0.20 vs. 0.49±0.28, p=0.02). In addition, the EPA/AA ratio was inversely correlated with late luminal loss in the stented lesions (r=-0.23, p=0.028). Multivariate logistic regression analysis showed that a low EPA/AA ratio (<0.41 determined by receiver operating characteristics analysis) was an independent predictor of ISR, after adjusting for clinical factors and procedural variables known to be associated with ISR (odds ratio, 4.35; 95% CI, 1.07-9.88; p<0.037).
Conclusion: The present findings indicate that the baseline plasma EPA/AA ratio is an independent predictor of late ISR after PCI with bare metal stents in AMI patients and may be a potential therapeutic target.
- © 2012 by American Heart Association, Inc.