Nutritional preconditioning by marine omega-3 fatty acids in patients with ST-segment elevation myocardial infarction: A METOCARD-CNIC trial substudy

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• 作者：Aleix Sala-Vila ; DPharm PhD^a ; ^b ; ¹ ; Rodrigo Ferná ; ndez-Jimé ; nez ; MD^c ; ^d ; ¹ ; Gonzalo Pizarro ; MD^c ; ^e ; Carlos Calvo ; BSc^a ; ^b ; Jose M Garcí ; a-Ruiz ; MD^c ; Leticia Ferná ; ndez-Friera ; MD PhD^c ; ^f ; Maite D Rodriguez ; RN^c ; Noemí ; Escalera ; BPT^c ; Jorge Palazuelos ; MD PhDⁱ ; Angel Mací ; as ; Tech^c ; Braulio Pé ; rez-Asenjo ; BPT^c ; Antonio Ferná ; ndez-Ortiz ; MD PhD^c ; ^d ; Emilio Ros ; MD PhD^a ; ^b ; Valentí ; n Fuster ; MD PhD^c ; ^g ; Borja Ibá ; ñ ; ez ; MD PhD^c ; ^h ; ^{bibanez@cnic.es}
• 关键词：AA ; arachidonic acid (C20 ; 4n-6) ; CMR ; cardiac magnetic resonance ; DHA ; docosahexaenoic acid (C22 ; 6n-3) ; EPA ; eicosapentaenoic acid (C20 ; 5n-3) ; IHD ; ischemic heart disease ; LCn3PUFA ; long-chain n-3 (omega-3) polyunsaturated fatty acids ; LVEF ; left ventricular ejection fraction ; RBC ; red blood cell ; STEMI ; ST-segment elevation myocardial infarction
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：828-833
• 全文大小：273 K
• 卷排序：228

文摘

Marine omega-3 eicosapentaenoic acid (EPA) is readily incorporated into cardiomyocyte membranes, partially displacing the omega-6 arachidonic acid (AA). Whereas AA is a substrate for pro-inflammatory eicosanoids, the release of EPA from cell membranes generates anti-inflammatory lipid mediators, contributing to the infarct-limiting effect observed experimental models. Clinical data are lacking.MethodsIn this observational study conducted in 100 patients with a reperfused anterior ST-elevation myocardial infarction (STEMI), at hospital admission we quantified by gas-chromatography the red blood cell proportions of AA, EPA, and the AA:EPA ratio, a valid surrogate for cardiomyocyte membrane content. Patients underwent cardiac magnetic resonance imaging in the acute phase (one week post-STEMI), and at long-term (6 months) follow-up. Infarct size (delayed gadolinium enhancement) and cardiac function (left ventricular ejection fraction [LVEF]) were correlated with exposures of interest by multivariate regression analysis.ResultsAA:EPA ratio directly related to acute infarct size (coefficient [95% CI]: 6.19 [1.68 to 10.69], P = 0.008) and inversely to long-term LVEF (coefficient [95% CI]: − 4.02 [− 7.15 to − 0.89], P = 0.012). EPA inversely related to acute infarct size (coefficient [95% CI]: − 6.58; [− 11.46 to − 1.70]; P = 0.009), while a direct association with LVEF at follow-up (coefficient [95% CI]: 3.67 [0.25 to 7.08]; P = 0.036) was observed.ConclusionsA low AA:EPA ratio in red blood cells at the time of STEMI is associated with smaller acute infarct size and preserved long-term ventricular function. Our results are consistent with prior work in experimental models and add to the notion of omega-3 fatty acids as a healthy fat.Trial registrationhttp://www.clinicaltrials.gov/NCT01311700