Abstract 17689: Omega-3 Fatty Acid Supplementation Reduces Inflammation and Improves Physical Function in Patient With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Abdulhamied Alfaddagh ◽  
Francine K Welty
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Physical Function ◽  
Control Group ◽  
P Value ◽  
Omega 3 ◽  
Artery Disease ◽  
One Year ◽  
Wbc Count

Introduction: Poor physical function impairs fitness and is associated with worse cardiovascular outcomes and all-cause mortality. Arthritis and joint dysfunction limit physical function in coronary artery disease (CAD) patients. Hypothesis: Omega-3 fatty acids (FA) improve physical function in CAD patients through reducing inflammation. Methods: We randomized 249 subjects with stable CAD to 3.6 of omega-3 FA (1.86 g of eicosapentaenoic acid + 1.5 g of docosahexaenoic acid) per day or no omega-3 (control) for one year. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to evaluate pain, stiffness and physical function at baseline and one year follow-up. Inflammation was assessed by total white blood cell (WBC) count and its subsets as well as urine microalbumin-creatinine ratio (MCR). Results: Mean age was 63.0 ± 7.58 years; 17% were women. Controls had worsening stiffness (% Δ = 8.4%; p = 0.036) at 1 year follow-up while those on omega-3 FA had no change (% Δ = 0.4%, p = 0.886 - see Table)(a lower percent change indicates better functioning). Compared to controls, those on omega-3 FA had better physical function (% Δ = 8.5% vs. -2.8%, p = 0.011), and total WOMAC scores (% Δ = 7.8% vs. -2.5%, p = 0.011) and a significant decrease in WBC (% Δ = -3.5 vs. -9.4%; p=0.009) and neutrophils (% Δ = -3.5% vs. -11.6%; p=0.005) at one year follow-up. MCR significantly worsened only in the control group (% Δ = 53.3%, p = 0.037) at one year follow-up (p-value for control vs. omega-3 FAs groups = 0.026). Monocytes were decreased in the omega-3 FAs group at one year compared to baseline (% Δ = -11.1%, p < 0.001) and directly correlated with physical function and total scores (p = 0.033 and p = 0.024, respectively). Conclusions: Omega-3 FAs attenuate worsening of physical function over a one year period in CAD patients possibly mediated through an anti-inflammatory effect. Therefore, omega-3 FA may benefit CAD patients by improving their physical function.

Abstract 15530: Omega-3 Fatty acids Supplementation Attenuates the Progression of Microalbuminuria in Diabetics With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dharshan K Lakshminarayan ◽  
Tarec K Elajami ◽  
Michael Soliman ◽  
Abdulhamied Alfaddagh ◽  
Francine K Welty
Keyword(s):  
Coronary Artery Disease ◽  
Fatty Acids ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Artery Disease ◽  
Stable Cad ◽  
One Year

Introduction: Microalbuminuria is a marker of generalized endothelial dysfunction, a key step in the pathogenesis of coronary artery disease (CAD). It is also an independent predictor of cardiovascular morbidity and mortality. Angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy is considered a standard of care to attenuate progression of albuminuria in diabetic patients. Hypothesis: Omega-3 fatty acids (FAs) supplementation will attenuate progression of microalbuminuria in diabetic subjects with stable CAD. Method: In our study, 262 subjects with stable CAD were randomized to 3.6 g of omega-3 FAs (1.86 g of eicosapentaenoic acid + 1.5 g of docosahexaenoic acid) per day or no omega-3 FA (control) for one year. Urine microalbumin to creatinine ratio (urine MCR mg/g) was calculated as a measure of microalbuminuria at baseline and one year follow-up. Results: Mean age was 63.3 ± 7.6 yrs, 17% were women, 30% had diabetes, and 74% were on ACEI or ARB therapy. At one year follow-up in non-diabetics, there was no significant difference in the % change in urine MCR between the omega-3 FAs and control groups (see table). In contrast in diabetics, those not receiving omega-3 FAs had a significant 72.3% increase in urine MCR whereas those receiving omega-3 FAs had no change (table). In subgroup analysis, diabetics on an ACEI or ARB receiving omega-3 FAs had no change in urine MCR whereas those not receiving omega-3 FAs had a 64.2% increase at one year follow-up. Conclusions: Omega-3 FAs attenuated worsening of urine MCR in diabetics with CAD compared to diabetics not receiving omega-3 FAs over a one year period. Our results suggest that a combination of omega-3 FAs and ACEI or ARB is better in attenuating the progression of microalbuminuria than ACEI or ARB alone in diabetics with CAD. This suggests that omega-3 FAs may provide additional benefit when added to ACEI/ARB in diabetics with CAD.

PLATELET REACTIVITY AND FIBRINOGEN LEVELS IN UNSTABLE CORONARY ARTERY DISEASE(UCAD)

1987 ◽  
Author(s):  
E Swahn ◽  
H von Schenck ◽  
L Wallentin
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Acute Phase ◽  
Fibrinogen Level ◽  
Platelet Reactivity ◽  
Control Group ◽  
Predisposing Factor ◽  
Unstable Phase ◽  
Artery Disease ◽  
One Year

Unstable angina and non-Q-wave myocardial infarction represents the unstable phase Of coronary artery disease (CAD). In UCAD a thrombosis in a coronary artery could be the triggering factor of the unstable phase. Increased platelet reactivity and hypercoagulability could be the predisposing factor for developing this condition. Therefore, in patients with UCAD the platelet reactivity was measured as the aggregation response to ADP and collagen, the platelet sensitivity to PgI2 and the release of platelet derived proteins. As an indicator of hypercoagulability the fibrinogen level in plasma was analysed. The control group consisted of patients with chest pain but without CAD. Blood samples for platelet tests and fibrinogen analysis were obtained in the acute phase and after one year.Results.: The only difference in platelet reactivity between cases and controls was noted in their sensitivity to PgI2. The difference remained in the females but not in the male UCAD group after one year.In the acute phase a diagnosis of UCAD, elevated weight index and smoking contributed independently to increased fibrinogen levels.Conclusion: The increased fibrinogen level and decreased platelet sensitivity to PgI2 might reflect a hypercoagulable state in patients with UCAD.

Abstract P224: The Haptoglobin (Hp) Genotype Predicts Coronary Artery Disease (CAD) During 25 Years of Follow-up in Type 1 Diabetes: Potential Pole of Impaired HDL Cholesterol Efflux Capacity

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tina Costacou ◽  
Jay W Heinecke ◽  
Tomas Vaisar ◽  
Trevor J Orchard
Keyword(s):  
Coronary Artery Disease ◽  
Type 1 Diabetes ◽  
Coronary Artery ◽  
Pilot Study ◽  
Cholesterol Efflux ◽  
P Value ◽  
Increased Risk ◽  
Artery Disease

Background: The Hp 2-2 genotype has been associated with increased cardiovascular risk in type 2 diabetes, potentially relating to dysfunctional HDL mediated cholesterol efflux. We have shown that the Hp 2 allele predicts the development of both coronary artery disease (CAD) and kidney dysfunction also in childhood onset type 1 diabetes over 18 years of follow-up in the Epidemiology of Diabetes Complications (EDC) study. We now present results on the Hp-CAD association after an additional 7 year follow-up and Hp’s relation to impaired sterol efflux capacity, a proposed cardioprotective effect of HDL. Methods: Participants free of CAD at baseline and with Hp determined were studied (n=565; mean age, 27 and duration, 19 years; 11.5% Hp 1-1, 42.5% Hp 2-2). CAD was defined as EDC physician diagnosed angina, ischemic ECG changes (MC 1.3, 4.1-4.3, 5.1-5.3, 7.1), confirmed MI (MC 1.1, 1.2 or validated medical records), stenosis >50%, revascularization or CAD death. In a pilot study, serum HDL sterol efflux was assessed in Mifepristone stimulated ABCA1-BHK cells among 20 individuals (6 Hp 1-1; 7 Hp 2-1; 7 Hp 2-2) attending the 25 year exam. Results: During follow-up, 186 (32.9%) developed CAD. Incidence increased with the number of Hp 2 alleles (24.6% in Hp 1-1, 31.1% in Hp 2-1 and 37.1% in Hp 2-2, p-trend=0.04; Fig. 1). Multivariably, Hp 2-2 significantly increased risk by almost 80% (HR=1.79, 1.03-3.09). The risk associated with Hp 2-1 did not reach significance (HR=1.46, 0.85-2.53). In the pilot study, serum HDL sterol efflux was lower in Hp 2 allele carriers: 14.0% in Hp 1-1, 12.5% in Hp 2-1, 12.4% in Hp 2-2, p-trend=0.06, p-value Hp 1-1 vs Hp 2-1/2-2 =0.04. Conclusion: These results extend our previous findings of increased CAD risk associated with the Hp 2 allele in type 1 diabetes and further suggest that this allele associates with impaired sterol efflux capacity. These results support the hypothesis that sterol efflux explains the increased Hp 2 risk for CAD and should be confirmed prospectively. Figure 1. CAD-free survival curves by Hp genotype

One-year follow-up of cardiac and coronary artery disease in infants and children with Kawasaki disease

1988 ◽  
Vol 115 (6) ◽  
pp. 1263-1267 ◽  
Author(s):  
Kyung J Chung ◽  
David R Fulton ◽  
Richard Lapp ◽  
Stephen Spector ◽  
David J Sahn
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Infants And Children ◽  
Artery Disease ◽  
One Year ◽  
In Infants And Children
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