Multiple differences between patients who initiate fish oil supplementation post–myocardial infarction and those who do not: the TRIUMPH Study

Harris, William S.; Kennedy, Kevin F.; Maddox, Thomas M.; Kutty, Shelby; Spertus, John A.

doi:10.1016/j.nutres.2015.11.006

Cited by 8 publications

(6 citation statements)

References 40 publications

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“…Estimated PUFA intakes derived from food records are inferior to circulating PUFA levels as indicators of PUFA exposure 64, 65 , and the effects of genetic variants on PUFA levels, while substantial for ARA 66 , are minimal to non-existent for EPA and DHA 67 . Finally, the inability to rule out the possibility of residual or unmeasured confounding also precludes inferences about causality 68 .…”

Section: Discussionmentioning

confidence: 99%

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

Harris

Luo

Pottala

et al. 2017

Journal of Clinical Lipidology

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Background The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is 4unclear. Objectives To determine the associations between red blood cell (RBC) PUFA levels and risk for death. Methods This prospective cohort study included 6501 women aged 65–80 who participated in the Women’s Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFA of secondary interest included the two major n-6 PUFAs, linoleic (LA) and arachidonic (ARA), and the PUFA Factor score (a calculated variable including 6 PUFAs that accounts for their inter-correlations). The primary outcome was total mortality through August 2014. Results After a median of 14.9 years of follow-up, 1851 (28.5%) women had died. RBC levels of EPA and DHA were higher in the survivors (p<0.002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1-SD PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA Factor score. There were no significant associations of alpha-linolenic acid or ARA or LA with total mortality. Conclusions Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes. ClinicalTrials.gov Identifier NCT00000611 (WHIMS).

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Section: Discussionmentioning

confidence: 99%

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

Harris

Luo

Pottala

et al. 2017

Journal of Clinical Lipidology

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“…The assessment of PUFA exposure at only onetime point cannot capture PUFA status changes throughout follow-up. Finally, the inability to rule out the possibility of residual or unmeasured confounding also precludes inferences about causality 31 .…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Erythrocyte n-6 Fatty Acids and Risk for Cardiovascular Outcomes and Total Mortality in the Framingham Heart Study

Harris¹,

Tintle²,

Vasan³

2018

Preprint

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Background: The prognostic value of erythrocyte levels of the n-6 fatty acids (FAs) for total mortality and cardiovascular disease (CVD) outcomes remains an open question. Methods: We examined CV outcomes and death in 2500 individuals in the Framingham Heart Study Offspring cohort without prevalent CVD (mean age 66 years, 57% women) as a function of baseline levels of different length n-6 FAs (18 carbon, 20 carbon and 22 carbon) in the erythrocyte membranes. Clinical outcomes were monitored for up to 9.5 years (median follow up, 7.26 years). Cox proportional hazards models were adjusted for a variety of demographic characteristics, clinical status and RBC n-6 and long chain n-3 FA content. Results: There were 245 CV events, 119 CHD events, 105 ischemic strokes, 58 CVD deaths, and 350 deaths from all causes. Few associations between either mortality or CVD outcomes were observed for the n-6 FAs, with those that were observed becoming non-significant after adjusting for n-3 FA levels. Conclusions: Higher circulating levels of the marine n-3 FA levels are associated with reduced risk for incident CVD and ischemic stroke and for death from CHD and all-causes, however in the same sample, little evidence exists for association with n-6 FAs. Further work is needed to identify a full profile of FAs associated with cardiovascular risk and mortality.

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“…The assessment of PUFA exposure at only one time point cannot capture PUFA status changes throughout follow-up. Finally, the inability to rule out the possibility of residual or unmeasured confounding also precludes inferences about causality [29].…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte n-6 Fatty Acids and Risk for Cardiovascular Outcomes and Total Mortality in the Framingham Heart Study

2018

View full text Add to dashboard Cite

Background: The prognostic value of erythrocyte levels of n-6 fatty acids (FAs) for total mortality and cardiovascular disease (CVD) outcomes remains an open question. Methods: We examined cardiovascular (CV) outcomes and death in 2500 individuals in the Framingham Heart Study Offspring cohort without prevalent CVD (mean age 66 years, 57% women) as a function of baseline levels of different length n-6 FAs (18 carbon, 20 carbon, and 22 carbon) in the erythrocyte membranes. Clinical outcomes were monitored for up to 9.5 years (median follow up, 7.26 years). Cox proportional hazards models were adjusted for a variety of demographic characteristics, clinical status, and red blood cell (RBC) n-6 and long chain n-3 FA content. Results: There were 245 CV events, 119 coronary heart disease (CHD) events, 105 ischemic strokes, 58 CVD deaths, and 350 deaths from all causes. Few associations between either mortality or CVD outcomes were observed for n-6 FAs, with those that were observed becoming non-significant after adjusting for n-3 FA levels. Conclusions: Higher circulating levels of marine n-3 FA levels are associated with reduced risk for incident CVD and ischemic stroke and for death from CHD and all-causes; however, in the same sample little evidence exists for association with n-6 FAs. Further work is needed to identify a full profile of FAs associated with cardiovascular risk and mortality.

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Multiple differences between patients who initiate fish oil supplementation post–myocardial infarction and those who do not: the TRIUMPH Study

Cited by 8 publications

References 40 publications

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

Erythrocyte n-6 Fatty Acids and Risk for Cardiovascular Outcomes and Total Mortality in the Framingham Heart Study

Erythrocyte n-6 Fatty Acids and Risk for Cardiovascular Outcomes and Total Mortality in the Framingham Heart Study

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