rogression of coronary atherosclerosis and rupture of unstable plaque are key processes in acute myocardial infarction (AMI). The extent of coronary artery disease has been well documented as a major prognostic factor in patients with AMI. Prevention and evaluation of the progression of atherosclerotic plaque volume is thus essential to both reduce cardiac events and estimate prognosis after AMI.Evidence that supplementation with n-3 polyunsaturated fatty acids prevents atherosclerosis-related cardiovascular risk has been accumulating. 1,2 More recently, a large randomized study demonstrated that eicosapentaenoic acid (EPA) is effective in preventing major coronary events in patients with hyperlipidemia. 3 Dysfunction of the vascular endothelium, fatty streak formation and fibrous cap formation are processes in the formation of atherosclerotic lesions that are regulated by the action of vasoactive molecules, growth factors, cytokines, and lipid metabolites. Several studies have demonstrated that supplementation with n-3 polyunsaturated fatty acids attenuates the exaggerated platelet aggregation induced by various stimuli, 4,5 attenuates the action of growth factors and cytokines, 5-7 reduces the serum triglyceride concentration, 8,9 and increases high-density lipoprotein levels. 8 There are several methods of evaluating coronary atherosclerotic lesions. Coronary angiography is widely used as the gold-standard to determine coronary stenosis, but it can only detect a luminal reduction in stenosis, collateral patterns and the presence of dense calcification of the coronary arteries, not plaque quantity. Coronary angioscopy and intravascular ultrasound (IVUS) can provide information about plaque characteristics to some extent, 10-14 but the observation areas are somewhat restricted and the methods are quite invasive. Multidetector spiral computed tomography (MDCT) with high slice numbers is now providing sufficient time and spatial resolution power to detect coronary atherosclerosis. 15,16 Its reliability in the determination of coronary plaque morphology has been recently demonstrated by studies using IVUS and histopathologic studies. 17,18 The advantages of MDCT are that it is relatively noninvasive compared with intracoronary angioscopy and IVUS, and has sufficient stability for observation of the entire coronary tree. Indeed, at present, MDCT is thought to be 1 of the best methods of evaluating coronary plaque characteristics.Based on these lines of evidence, we hypothesized that serum n-3 polyunsaturated fatty acid levels would correlate with the extent of coronary atherosclerotic lesions. The Background The relationship between serum fatty acid levels and the extent of coronary plaques and calcification was examined in patients with acute myocardial infarction (AMI).
Methods and ResultsThe serum levels of the n-3 polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) and the n-6 polyunsaturated fatty acids (arachidonic acid (AA) and dihomogamma-linolenic acid (DGLA)) were det...