Abstract 14551: Lower Omega-3 Fatty Acid Levels Could Predict Coronary Plaque Vulnerability in Patients With Coronary Artery Disease
Background: Accumulating evidences have revealed the robust relationship between aberrant serum lipid profiles and coronary artery disease (CAD). However, the question whether the altered serum lipid profiles would reflect the plaque instability in coronary artery disease has been still elusive. Thus, we investigated the relationship between plaque instability of coronary artery and serum lipid profiles in the CAD patients.
Methods: In consecutive 595 patients who underwent coronary angiography due to CAD from August 2009 to October 2012, serum lipid profiles including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DHLA) were measured. Patients were divided into 3 groups as follows, (1) patients with acute coronary syndrome (ACS) in early phase (< 7 days from admission; group A, n=96), (2) patients with effort angina with previous history of ACS (group B, n=259), and (3) patients without previous history of ACS (group C, n=240). Patients who have already taken ethyl icosapentate were excluded from study entry.
Results: (1) Although baseline patient characteristics including gender, age, body mass index, and previous history of hypertension were not different among the 3 groups, the incidence of dyslipidemia and diabetes were lower, and current smoking was higher in group A. (2) Plasma fatty acid fractions revealed that serum EPA levels were significantly lower in group A than those in others (52.2 μg/ml vs. 73.8 μg/ml of group B, P<0.001, vs. 85.0 μg/ml of group C, P<0.001). DHA (116 μg/ml vs. 136 μg/ml of group B, P=0.002, vs. 149.4 μg/ml of group C, P<0.001) and EPA/AA ratio (0.36 vs. 0.47 of group B, P=0.005, vs. 0.53 of group C, P<0.001) were also significantly lower in group A. In group B, EPA (P=0.009), DHA (P=0.005), and EPA/AA ratio (P=0.07) were lower than those of group C.
Conclusion: Altered lipid profiles were significant in patients with suspected plaque instability, that is, patients with recent ACS and previous history of ACS. Thus, lower EPA and/or DHA may reflect a coronary plaque vulnerability which promotes ACS.
- © 2013 by American Heart Association, Inc.