Background:
Until now, Omega-3/Omega-6 polyunsaturated fatty acid (PUFA) ratio, particularly in ratio of eicosapentaenoic acid (EPA) to arachnidonic acid (AA), has been reported to associate with the incidence of cardiovascular events. However, the clinical impact of monounsaturated fatty acid (MUFA) on cardiovascular events has not been well understood.
Objective:
In this study, we evaluate whether ratio of MUFA to PUFA, especially EPA/Oleic acid (OA), could predict clinical outcome in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI).
Methods:
SHINANO registry was prospective, observational, multicenter cohort study, enrolling 1,923 consecutive patients with CAD. From this registry, we identified 182 patients who measured fatty acid on admission. We stratified according to median of EPA/OA ratio. The primary endpoint was net adverse clinical events (NACE) including cardiac death, nonfatal myocardial infarction, ischemic stroke, PCI for ACS, heart failure, and major bleeding (Bleeding Academic Research Consortium II-IV) for 1-years.
Results:
Mean age was 72±10 years, 24% female, and 27% was acute coronary syndrome. One-years follow-up was completed in 181 patients (99.5%). Cumulative incidence of NACE was 22 cases. In Kaplan-Meier analysis, incidence of NACE was significantly higher in patients with EPA/OA of 0.03 to 0.12 compared to 0.13 to 0.54 (16.6% vs. 6.6%, Log-rank p=0.025). After adjusting for the calculated propensity score for EPA/OA ≥ 0.13 or not, EPA/OA ≥ 0.13 was remained an independent predictor of NACE (hazard ratio, 0.36; 95% confidence interval [CI], 0.14-0.96; p-value 0.042). The ROC curve of EPA/OA for NACE demonstrated that the area under the ROC curve (ACU) was 0.73 (95% CI; 0.61-0.85).
Conclusions:
This study firstly demonstrated that the patients with high EPA/OA ratio would have low incidence of NACE in patients with CAD who underwent PCI.
Which has the stronger impact on coronary artery disease, eicosapentaenoic acid or docosahexaenoic acid?
