Plasma n-3 polyunsaturated fatty acids in chronic heart failure in the GISSI-Heart Failure Trial: Relation with fish intake, circulating biomarkers, and mortality

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• 作者：Serge Masson ; PhD^a ; ^k ; ^l ; Roberto Marchioli ; MD^b ; ^k ; ^l ; Dariush Mozaffarian ; MD^c ; Roberto Bernasconi^a ; Valentina Milani ; MS^a ; ^k ; Luana Dragani^d ; Mariateresa Tacconi ; PhD^a ; Rosa Maria Marfisi ; MS^b ; Luisa Borgese ; MD^e ; ^k ; Vincenzo Cirrincione ; MD^f ; ^k ; Oreste Febo ; MD^g ; ^k ; Enrico Nicolis ; MS^a ; Aldo P. Maggioni ; MD^h ; ^k ; Gianni Tognoni ; MDⁱ ; ^k ; Luigi Tavazzi ; MD^j ; ^k ; Roberto Latini ; MD^a ; ^k ; ^{roberto.latini@marionegri.it}
• 刊名：American Heart Journal
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：165
• 期：2
• 页码：208-215.e4
• 全文大小：536 K

文摘

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Background

Treatment with long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) can improve clinical outcomes in patients with heart failure (HF). Circulating levels of n-3 PUFA, an objective estimation of exposure, have never been measured in a large cohort of patients with HF.

Methods

We measured n-3 PUFA in plasma phospholipids at baseline and after 3 months in 1,203 patients with chronic HF enrolled in the GISSI-Heart Failure trial and randomized to n-3 PUFA 1 g/daily or placebo. N-3 PUFA levels were related to clinical characteristics, pharmacologic treatments, dietary habits, circulating biomarkers, and mortality.

Results

Baseline n-3 PUFA (5.1 ¡À 1.8 mol % ) was associated with dietary fish intake, with an average difference of 43 % between patients with the lowest and highest consumptions (P < .0001). Baseline eicosapentaenoic acid (EPA) but not docosahexaenoic acid (DHA) was inversely related to C-reactive protein, pentraxin-3, adiponectin, natriuretic peptide, and troponin levels. Three-month treatment with n-3 PUFA raised their levels by 43 % , independently of dietary fish consumption; increases in EPA levels were associated with decreased pentraxin-3. Low baseline levels of EPA but not DHA were no longer related to higher mortality after the addition of circulating biomarkers to multivariable models.

Conclusion

Before supplementation, circulating n-3 PUFA levels in patients with chronic HF mainly depend on dietary fish consumption and are inversely related to inflammatory markers and disease severity. Three-month treatment with n-3 PUFA markedly enriched circulating EPA and DHA, independently of fish intake, and lowered pentraxin-3. Low EPA levels are inversely related to total mortality in patients with chronic HF.