Low Levels of Serum n-3 Polyunsaturated Fatty Acids Are Associated With Worse Heart Failure-Free Survival in Patients After Acute Myocardial Infarction

Background: Intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFA), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), is associated with a lower risk of atherosclerotic cardiovascular events, particularly acute myocardial infarction (AMI). However, limited data are avail...

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Published in:Circulation Journal 2013, Vol.77(1), pp.153-162
Main Authors: Hara, Masahiko, Sakata, Yasuhiko, Nakatani, Daisaku, Suna, Shinichiro, Usami, Masaya, Matsumoto, Sen, Hamasaki, Toshimitsu, Doi, Yasuji, Nishino, Masami, Sato, Hiroshi, Kitamura, Tetsuhisa, Nanto, Shinsuke, Hori, Masatsugu, Komuro, Issei, for the Osaka Acute Coronary Insufficiency Study (OACIS) Investigators
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Aged
Disease-Free Survival
Docosahexaenoic acid
Docosahexaenoic Acids - blood
Eicosapentaenoic acid
Eicosapentaenoic Acid - blood
Female
Heart failure
Heart Failure - blood
Heart Failure - etiology
Heart Failure - mortality
Humans
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - complications
Myocardial Infarction - mortality
n-3 polyunsaturated fatty acids
Sex Factors
Survival Rate
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Summary:Background: Intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFA), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), is associated with a lower risk of atherosclerotic cardiovascular events, particularly acute myocardial infarction (AMI). However, limited data are available regarding the association between serum n-3 PUFA levels and heart failure (HF) events in survivors of AMI. Methods and Results: We evaluated whether serum DHA and EPA levels were associated with HF-free survival and HF hospitalization rates after AMI. A total of 712 patients were divided into 3 groups according to their tertile serum levels of DHA and EPA (Low, Middle, and High). Propensity-score-stratified Cox regression analysis revealed that DHA- and EPA-Low groups presented statistically significant worse HF-free survival (hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.03–2.72, P=0.0358, and HR 1.69, 95% CI 1.05–2.72, P=0.0280, respectively), with the EPA-Low group having a higher risk of HF hospitalization (HR 2.40, 95% CI 1.21–4.75, P=0.0097) than the DHA-Low group (HR 1.72, 95% CI 0.86–3.45, P=0.1224). The relationship between a low DHA or EPA level and decreased HF-free survival was almost common to all subgroups; however, the effect of low serum EPA on HF hospitalization was prominent in male patients, and those with low levels of high-density lipoprotein cholesterol or without statin therapy. Conclusions: Low levels of circulating n-3 PUFA are associated with decreased HF-free survival in post-AMI patients.  (Circ J 2013; 77: 153–162)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-12-0875