Abstract 10937: Impact of Serum n-3 to n-6 Polyunsaturated Fatty Acid Ratio on Coronary Plaque Composition as Assessed by iMap-intravascular Ultrasound
Background: A low serum n-3 to n-6 polyunsaturated fatty acid (PUFA) ratio is associated with cardiovascular events; however, the effects on coronary plaque characteristics have been unclear. This study examined whether serum n-3 to n-6 PUFA ratio is associated with plaque composition as assessed by iMap-intravascular ultrasound (iMap-IVUS), a novel radiofrequency intracoronary imaging system for plaque characterization.
Methods: We enrolled 92 patients (56 with stable angina pectoris, 36 with acute coronary syndrome) who underwent percutaneous coronary intervention following iMap-IVUS analysis to culprit lesions. Serum levels of n-3 PUFAs (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and n-6 PUFA (arachidonic acid [AA]) were measured, and the ratios (EPA/AA and DHA/AA) were calculated. Patients were divided into the following two groups according to median EPA/AA ratio: lower EPA/AA (n = 46, EPA/AA < 0.39) and higher EPA/AA (n = 46, EPA/AA ≥ 0.39). Plaque compositions were classified by iMap-IVUS as fibrotic, lipidic, necrotic and calcified, and each volume (fibrotic volume [FV], lipidic volume [LV], necrotic volume [NV] and calcified volume [CV], respectively) was reported as a percentage of the total plaque volume. We defined plaques with %NV ≥ 37.9% of median value as larger NV plaques.
Results: Patients with lower EPA/AA showed a higher prevalence of hypertension and increased levels of high-sensitivity C-reactive protein than those with higher EPA/AA. The %NV was significantly greater (42 ± 13% vs. 35 ± 13%, p = 0.009) and %FV was significantly smaller (46 ± 13% vs. 52 ± 14%, p = 0.024) in patients with lower EPA/AA than in those with higher EPA/AA. EPA/AA and DHA/AA ratios correlated inversely with %NV (r = –0.26, p = 0.014 and r = –0.26, p = 0.013, respectively) and positively with %FV (r = 0.22, p = 0.033 and r = 0.24, p = 0.021, respectively). Multivariate logistic regression analysis identified lower EPA/AA as the most powerful predictor of larger NV plaque (odds ratio, 3.75; 95% confidence interval, 1.58 - 8.93; p = 0.003).
Conclusion: Lower serum n-3 to n-6 PUFA ratio is associated with coronary plaque composition, particularly with larger %NV and smaller %FV.
- © 2013 by American Heart Association, Inc.