Relationships between Plasma Fatty Acid Composition and Coronary Artery Disease

Abstract

Aim:The Japan EPA Lipid Intervention Study (JELIS) was the first prospective randomized clinical trial to demonstrate prevention of coronary events by pure eicosapentaenoic acid (EPA). The aim of this study was to examine the relationships between various plasma fatty acid concentrations and the risk of coronary events in JELIS participants. Methods: In 15,534 participants, we calculated the hazard ratio for major coronary events (sudden cardiac death, fatal or nonfatal myocardial infarction, unstable angina pectoris, and angioplasty/ stenting or coronary artery bypass grafting) relative to the on-treatment average level of plasma fatty acids with the Cox proportional hazard model. Results: As a result of EPA intervention, the plasma EPA concentration increased, but the docosahexaenoic acid (DHA) concentration did not. The other fatty acids measured decreased slightly. The higher plasma level of EPA (hazard ratio 0.83, p 0.049, in all participants and hazard ratio 0.71, p 0.018, in the EPA intervention group), but not of DHA, was inversely associated with the risk of major coronary events. The associations between other fatty acids and the risk of major coronary events were not significant. In all JELIS participants, the risk of major coronary events was significantly decreased (20%) in the group with high (150 g/mL or more) on-treatment plasma EPA concentration compared with that in the low (less than 87 g/mL) group. Conclusion: The risk of coronary artery disease is influenced by variations in plasma fatty acid composition. Among n-3 polyunsaturated fatty acids, EPA and DHA exhibited differences in the correlation with the risk of major coronary events. J Atheroscler Thromb, 2011; 18:99-107.

Relationship between n-3 Polyunsaturated Fatty Acids and Extent of Vessel Disease in Patients with ST Elevation Myocardial Infarction

“…5,9,[19][20][21] In our study, however, they were not significantly different between the 3 groups, which may be attributed to the distribution of the serum AA level as shown in Figure 3C. We speculate that the dietary habits of the patients affect the distribution of the serum AA level.…”

Eicosapentaenoic Acid (EPA) Reduces Cardiovascular Events: Relationship with the EPA/Arachidonic Acid Ratio

“…In the JELIS trial, higher blood EPA levels in the EPA-E group were associated with a lower incidence of main coronary events (HR: 0.71, p = 0.018). No such relationships were observed for the blood DHA levels 21) ( Table 2). …”

“…3). In the JELIS study, 1.8 g/day of hp-EPA-E (Epadel ® ) resulted in increases in the blood EPA levels from 97 μg/mL to 166 μg/mL and the EPA/AA ratio from 0.599 to 1.085; the DHA levels decreased from 170 μg/mL to 156 μg/mL, and the AA levels decreased from 162 μg/mL to 153 μg/mL 39) . The administration of algae-derived DHA (39% purity; 1.62 g/day) altered the blood phospholipid EPA, DHA, AA and .…”

The Change in Low-Density Lipoprotein Cholesterol Concentration is Positively Related to Plasma Docosahexaenoic Acid but not Eicosapentaenoic Acid

“…It is important to consider age and sex as confounding factors to discuss the relationship between fatty acids in blood and clinical events, such as coronary artery disease. In addition, we previously investigated the quantities of change in serum lipids and plasma fatty acids, and the average age and sex distribution were also the same in any allocation group 12) . We determined the relative amount (mol%) and the absolute amount (μg/mL) of plasma fatty acids.…”

“…The design and inclusion and exclusion criteria were described in detail elsewhere 11) . At registration, 16,397 patients (control group, n = 8,076; EPA group, n = 8,321) gave their informed consent to annual blood sampling to test plasma fatty acids 12) . We obtained 13,901 samples (control group, n = 6,844; EPA group, n = 7,057) at baseline and final follow-up paired data.…”