TY - JOUR
T1 - Low levels of serum n-3 polyunsaturated fatty acids are associated with worse heart failure-free survival in patients after acute myocardial infarction
AU - Hara, Masahiko
AU - Sakata, Yasuhiko
AU - Nakatani, Daisaku
AU - Suna, Shinichiro
AU - Usami, Masaya
AU - Matsumoto, Sen
AU - Hamasaki, Toshimitsu
AU - Doi, Yasuji
AU - Nishino, Masami
AU - Sato, Hiroshi
AU - Kitamura, Tetsuhisa
AU - Nanto, Shinsuke
AU - Hori, Masatsugu
AU - Komuro, Issei
PY - 2013
Y1 - 2013
N2 - 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 EPALow 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.
AB - 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 EPALow 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.
KW - Acute myocardial infarction
KW - Docosahexaenoic acid
KW - Eicosapentaenoic acid
KW - Heart failure
KW - N-3 polyunsaturated fatty acids
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U2 - 10.1253/circj.CJ-12-0875
DO - 10.1253/circj.CJ-12-0875
M3 - Article
C2 - 23047296
AN - SCOPUS:84871687188
VL - 77
SP - 153
EP - 162
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 1
ER -