Abstract 16146: Clinical Significant of the Ratio of Eicosapentaenoic Acid to Arachidonic Acid as a Risk Marker for Coronary Artery Disease
Introduction: The plasma eicosapentaenoic acid to arachidonic acid ratio (EPA/AA), which is determined only by dietary intake, has been attracting attention as a new risk marker for coronary artery disease (CAD). A Japanese inland prefecture, Tochigi, ranks higher mortality rate from CAD and lower seafood consumption, compared to other prefectures. The aim of this study was to investigate the EPA/AA ratio in residents of Tochigi prefecture.
Methods and Results: We measured the EPA/AA ratio in patients undergoing diagnostic coronary angiography, because of suspicion for having CAD. In all of the patients, statins but not EPA agents were given. A total of 816 patients were enrolled in 7 centers around Tochigi prefecture. In overall patients, low-density lipoprotein cholesterol level was well controlled as 88±33 mg/dl. The median value of the EPA/AA ratio in all patients was 0.37. The EPA/AA ratio was lower in younger patients (<60 yrs), compared to elderly patients (≥60 yrs) (P<0.01). When subjects were divided into 10-year age groups, 30- to 39-year-old male and female patients displayed similar EPA/AA ratios. However, the EPA/AA ratios of 50- to 59-year old female patients (P<0.01) and 60- to 69-year old female patients (P<0.01) were significantly lower than those of age-matched male patients. In patients who did not have any conventional risk factors such as hypertension, diabetes, dyslipidemia or smoking, the EPA/AA ratio was lower in patients with multi-vessel CAD, compared to those with single-vessel CAD (P<0.001). The EPA/AA ratio was lower in patients with acute coronary syndrome (ACS), compared to those with stable angina (P<0.01) and those with coronary spastic angina (P<0.01). Multivariable analysis for discrimination of ACS from chronic CAD demonstrated that the EPA/AA ratio (F=7.978, P<0.01) as well as estimated glomerular filtration rate (F=4.001, P<0.05) was independent discriminators of ACS.
Conclusions: The EPA/AA ratio might be lower in younger patients and menopausal female patients suspected of CAD. In addition, the low EPA/AA ratio may be associated with coronary plaque instability as well as CAD severity, and thus, the EPA/AA ratio would be a new risk marker for CAD.
Author Disclosures: M. Sakuma: None. Y. Kitagawa: None. S. Abe: None. S. Toyoda: None. S. Watanabe: None. K. Ebisawa: None. Y. Murakami: None. T. Ando: None. H. Sugimura: None. I. Taguchi: None. T. Inoue: None.
- © 2014 by American Heart Association, Inc.