Abstract 17413: The Ratio of EPA/AA Associates With Age of Patient Undergoing Coronary Intervention and Frequency of ST-segmental Elevation Myocardial Infarction
BACKGROUNDS: Recent clinical trial demonstrated that an administration of high purity eicosapentaenoic acid (EPA) significantly decreased the incidence of coronary events in dyslipidemic patients. In addition, a subanalysis of secondary prevention revealed that the risk of MACE was significantly lower in the patients with a high serum EPA/arachidonic acid (AA) ratio compared with those with a low EPA/AA ratio. However, the relationships between fatty acid profiles and types of coronary artery disease are still unclear.
METHODS AND RESULTS: A total of 465 consecutive patients underwent percutaneous coronary intervention (PCI) in a single cardiovascular center from Jan.2010 till Dec.2011 was enrolled, and the values of their serum EPA and AA concentrations at the time of PCI were evaluated. As results of retrospective analyses, serum EPA concentration was significantly low, and AA was high in younger subpopulation aged <60-years old (n=76) compared with older subpopulation (n=383) (EPA: 45.4±30.3 vs. 66.2±42.8 ug/mL, p<0.01, AA: 188.1±55.0 vs. 156.8±44.5 ug/mL, p<0.01). Consequently, the ratio of EPA/AA of younger subpopulation was significantly lower than that of older one (0.245±0.145 vs. 0.455±0.369, p<0.01). Interestingly, the younger subpopulation suffered significantly higher rate of acute coronary syndrome (ACS) and ST elevation myocardial infarction (STEMI) than older subpopulation (66.7 vs. 36.7%, p<0.01, 41.3 vs. 20.2%, p<0.01, respectively). Moreover, in the older subpopulation, patients with lower ratio of EPA/AA (0.234±0.081, n=192) showed significantly high rate of ACS and STEMI than those with higher ratio (0.678±0.409, n=191) (42.9 vs. 30.4%, p=0.011, 27.9 vs. 12.6%, p<0.01, respectively), in spite of similar atherosclerotic indicators (Patients with PAD: 20.6 vs. 16.1%, p=0.279, Flow-mediated dilation: 3.4±1.6 vs. 3.1±1.8%, Pulse wave velocity: 1935±569 vs. 1877±510 cm/sec., p=0.714) and serum lipid profiles between the groups (LDL-C: 104.0±32.7 vs. 104.5±35.0 mg/dL, p=0.996, non-HDL: 126.8±36.8 vs. 130.3±36.5 mg/dL, p=0.415).
CONCLUSION: EPA/AA ratio was low in younger patients underwent PCI, and low EPA/AA ratio associated with higher rate of ACS and STEMI in both younger and older patients.
- © 2013 by American Heart Association, Inc.