Abstract 13464: Pentraxin 3 is Uninfluenced by High Doses of Concentrated Omega-3 Fatty Acids Administered for 12 Months Following an Acute Myocardial Infarction

Abstract

Background: Treatment with n-3 fatty acids has shown to improve outcome in patients with myocardial infarction (MI). However, the pathophysiological mechanisms of their beneficial effect are still being debated. Although anti-inflammatory mechanisms have been postulated, their influence on high sensitivity C-reactive protein (hs-CRP) is controversial. Hs-CRP belongs to the pentraxin family, so also does the recently identified long pentraxin 3 (PTX3) which has been found to reflect the inflammatory state of the vasculature and has been shown to predict outcome in MI patients. The aim of the present analysis was to assess the effect of long-term treatment with high doses of omega-3 fatty acids on circulating plasma levels of PTX3.

Methods: In the OFAMI study (ClinicalTrials.gov; NCT01422317), 300 MI patients were randomised to blindly receive 4 gelatine capsules of omega-3 in a concentrated ethylester form, each capsule containing 850-882 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Omacor, Pronova A/S, Oslo, Norway), or 4 g of corn oil, administered daily for a period of 12 months. Blood samples were collected 4-6 days following admission (just prior to intervention) and after a treatment period of 12 months. PTX3 was determined in citrated plasma by a specific enzyme-linked immunoabsorbent assay (ELISA) based on antibodies and reference protein developed in-house. Sensitivity is 100 pg/ml and no cross reaction with CRP is evident.

Results: A complete dataset for the analysis of PTX3 was available in 234 patients. PTX3 levels correlated well with hsCRP (r=0.40; p<0.01) and N-terminal Pro Brain Natriuretic Peptide (NTproBNP) (r=0.30; p<0.01) but not with troponin T (TnT), CD40L and serum lipids. During the intervention period, PTX3 decreased in both treatment groups; in the omega-3 group from median 3.60 to 3.15 ng/mL (p<0.01) and in controls from median 4.25 to 3.32 ng/mL (p<0.01). However, there was no statistical significant inter-group difference in PTX3 change.

Conclusion: PTX-3 levels were unaffected by high-dosed omega-3 fatty acids during an intervention period of 12 months in acute MI patients.