Abstract 15541: Association between Eicosapentaenoic Acid to Arachidonic Acid Ratio and Coronary Plaques as Detected by Coronary Computed Tomography Angiography in Patients with Suspected Coronary Artery Disease

Abstract

Backgrounds: Epidemiological studies have demonstrated that the intake of n-3 polyunsaturated fatty acids (PUFAs) and serum n-3 to n-6 PUFA level ratios are related to major cardiovascular events. Moreover, pure eicosapentaenoic acid (EPA) reduced major coronary events in Japanese hypercholesterolemic patients.

We examineded the association of serum n-3 to n-6 PUFA level ratios to the presence and extent of coronary plaques and their characteristics as detected by coronary computed tomography angiography (CCTA) in patients withsuspected coronary artery disease (CAD).

Methods: In this study, we enrolled 380 subjects (age; 66.2 years, 71.6% men) and assessed the coronary plaques in all coronary segments (segs) >2mm. Coronary plaques were classified as calcified (CP), partially calcified (PCP) or non-calcified (NCP). In patients who had PCPs or NCPs, we analyzed coronary plaque vulnerable characteristics based on our previous reports for low-density plaque (LDP: minimum CT density ≤38 Hounsfield units), positive remodeling (PR: remodeling index >1.05) and spotty calcification (SC: calcified length < 3/2 and width < 2/3 vessel diameter) In addition, we measured PUFA levels and then calculated EPA to arachidonic acid (AA) ratios. We divided the subjects into two groups: lower (≤ 0.385) and higher EPA/AA ratio (> 0.385) group.

Results: The lower EPA/AA group had greater presence and extent of PCPs and/or NCPs in comparison to the higher group (59.0% vs. 43.7%, p< 0.01, 1.4 ± 1.8 segs vs. 1.0 ± 1.6 segs, p< 0.01). Moreover, the lower EPA/AA group also had a greater presence of all three vulnerable components (22.1% vs. 9.5%, p< 0.01). After adjusting for age, gender and traditional coronary risk factors, the EPA/AA ratio remained an independent factor for the presence and extent of PCPs and/or NCPs (odds ratio [OR] 2.00, 95% confidence interval [CI] 1.29-3.15, p< 0.01; β-estimate 0.42, 95% CI 0.09-0.74, p< 0.05). In addition, lower EPA/AA ratios remained an independent predictor for the presence of all three vulnerable components (OR 2.74, 95% CI 1.52-5.14, p< 0.01).

Conclusion: Lower serum EPA/AA ratio is associated with the presence and extent of PCPs and/or NCPs and plaque vulnerable characteristics as detected by CCTA in patients with suspected CAD.