Low levels of omega-3 fatty acids tied to early onset coronary atherosclerosis

  • Bittner DO & al.
  • Eur J Clin Nutr
  • 2 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Low levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with early onset of coronary atherosclerosis in symptomatic patients.

Why this matters

  • The effect of EPA and DHA on vascular calcification in humans is unclear.
  • This study improves our understanding of the pathophysiology of omega-3 fatty acids, which potentially explains their beneficial effects.

Study design

  • Prospective analysis of symptomatic patients with low to intermediate pre-test-likelihood who presented with atypical angina (n=71).
  • Patient characteristics: mean age, 62 years; mean BMI, 28 kg/m2; mean number of cardiovascular risk factors, 2.4.
  • The presence of coronary artery calcification (CAC) above 75th percentile was calculated (defined as association of EPA and DHA with early-onset coronary atherosclerosis).
  • Funding: None disclosed.

Key results

  • The groups with 75th (n=20) Agatston-Score (AS) percentile showed a significant difference in CAC measurements (including CAC volume, mass, and AS; all P<.001>
  • In the group >75th vs
  • EPA (0.77% vs 0.93%; P=.045);
  • DHA (4.90% vs 5.50%; P=.038); and
  • Omega-3 Index (5.73% vs 6.22%; P=.034).
  • No significant differences were noted with other fatty acids.
  • Multivariable analysis revealed a significant inverse association between Omega-3 Index and early onset of CAC (OR, 0.533; P=.029).
  • This significant association was independent of age (P=.319), sex (P=.634), statin use (P=.107) and creatinine level (P=.061).
  • Limitations

    • Small sample size.
    • Intake of EPA- and DPA-rich sources not assessed.