Dennis W T Nilsen1, Hildegunn Aarsetoey2, Volker Pönitz3, Trygve Brugger-Andersen3, Harry Staines4, William S Harris5, Heidi Grundt6. 1. Division of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway; Department of Clinical Science, University of Bergen, 5020 Bergen, Norway. Electronic address: nide@sus.no. 2. Department of Medicine, Stavanger University Hospital, 4068 Stavanger, Norway. 3. Division of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway. 4. Sigma Statistical Services, KY16 0BJ Balmullo, UK. 5. Sanford School of Medicine, University of South Dakota, OmegaQuant Analytics, LLC, Sioux Falls, SD, United States. 6. Department of Medicine, Stavanger University Hospital, 4068 Stavanger, Norway; Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
Abstract
BACKGROUND: We previously investigated the prognostic utility of red blood cell (RBC) n-3 fatty acids (FAs) in survivors of an acute myocardial syndrome (ACS) but found no relationship with all-cause mortality and cardiac death or MI after two years. Here we extend our follow-up to 7years, focusing on the potential predictive power of RBC n-6 FAs. METHODS: We included 398 ACS patients presenting with increased troponin-T (TnT) levels for whom baseline RBC FA data were available. Cox regression analysis was used to relate the risk of future events to RBC n-6 FA levels, both continuously and by quartile. RESULTS: At 7-year follow-up, 183 (46.0%) had died, 128 (32.2%) had experienced another MI and 24 (6.0%) had had a stroke. Death or MI occurred in 227 patients (57.0%); and death, MI or stroke in 235 patients (59.0%). In a multivariable Cox regression model for total death, the hazard ratio (HR) in the highest as compared to the lowest quartile of dihomo-γ-linolenic acid (DGLA) was 0.55 [95% confidence interval (CI), 0.35-0.88, p=0.012, for death or MI [HR 0.62 (95% CI, 0.41-0.94), p=0.025], and for the fully combined endpoint [HR 0.57 (95% CI, 0.38-0.86), p=0.006]. Similar results were found in the per 1-SD analysis. No other RBC n-6 FAs significantly predicted these outcomes in multivariable models. CONCLUSION: RBC DGLA levels had significant independent prognostic value in post-ACS patients. These findings need confirmation, and the possible biochemical pathways by which higher DGLA membrane levels may be cardioprotective should be explored.
BACKGROUND: We previously investigated the prognostic utility of red blood cell (RBC) n-3 fatty acids (FAs) in survivors of an acute myocardial syndrome (ACS) but found no relationship with all-cause mortality and cardiac death or MI after two years. Here we extend our follow-up to 7years, focusing on the potential predictive power of RBC n-6 FAs. METHODS: We included 398 ACS patients presenting with increased troponin-T (TnT) levels for whom baseline RBC FA data were available. Cox regression analysis was used to relate the risk of future events to RBC n-6 FA levels, both continuously and by quartile. RESULTS: At 7-year follow-up, 183 (46.0%) had died, 128 (32.2%) had experienced another MI and 24 (6.0%) had had a stroke. Death or MI occurred in 227 patients (57.0%); and death, MI or stroke in 235 patients (59.0%). In a multivariable Cox regression model for total death, the hazard ratio (HR) in the highest as compared to the lowest quartile of dihomo-γ-linolenic acid (DGLA) was 0.55 [95% confidence interval (CI), 0.35-0.88, p=0.012, for death or MI [HR 0.62 (95% CI, 0.41-0.94), p=0.025], and for the fully combined endpoint [HR 0.57 (95% CI, 0.38-0.86), p=0.006]. Similar results were found in the per 1-SD analysis. No other RBC n-6 FAs significantly predicted these outcomes in multivariable models. CONCLUSION: RBC DGLA levels had significant independent prognostic value in post-ACS patients. These findings need confirmation, and the possible biochemical pathways by which higher DGLA membrane levels may be cardioprotective should be explored.
Authors: Sara Bonafini; Angela Tagetti; Rossella Gaudino; Paolo Cavarzere; Martina Montagnana; Elisa Danese; Marco Benati; Diego Alberto Ramaroli; Sara Raimondi; Alice Giontella; Anna Mantovani; Angela Donato; Andrea Dalbeni; Pietro Minuz; Franco Antoniazzi; Claudio Maffeis; Cristiano Fava Journal: Eur J Nutr Date: 2018-03-28 Impact factor: 5.614