title: n-3 Polyunsaturated fatty acids, fatal ischemic heart disease, and nonfatal myocardial infarction in older adults: the Cardiovascular Health Study.
abstract: BACKGROUND
  Little is known about the relation of the dietary intake of n-3 polyunsaturated fatty acids, ie, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from fatty fish and alpha-linolenic acid from vegetable oils, with ischemic heart disease among older adults.
  
  
  OBJECTIVE
  We investigated the associations of plasma phospholipid concentrations of DHA, EPA, and alpha-linolenic acid as biomarkers of intake with the risk of incident fatal ischemic heart disease and incident nonfatal myocardial infarction in older adults.
  
  
  METHODS
  We conducted a case-control study nested in the Cardiovascular Health Study, a cohort study of adults aged > or = 65 y. Cases experienced incident fatal myocardial infarction and other ischemic heart disease death (n = 54) and incident nonfatal myocardial infarction (n = 125). Matched controls were randomly selected (n = 179). We measured plasma phospholipid concentrations of n-3 polyunsaturated fatty acids in blood samples drawn approximately 2 y before the event.
  
  
  RESULTS
  A higher concentration of combined DHA and EPA was associated with a lower risk of fatal ischemic heart disease, and a higher concentration of alpha-linolenic acid with a tendency to lower risk, after adjustment for risk factors [odds ratio: 0.32 (95% CI: 0.13, 0.78; P = 0.01) and 0.52 (0.24, 1.15; P = 0.1), respectively]. In contrast, n-3 polyunsaturated fatty acids were not associated with nonfatal myocardial infarction.
  
  
  CONCLUSIONS
  Higher combined dietary intake of DHA and EPA, and possibly alpha-linolenic acid, may lower the risk of fatal ischemic heart disease in older adults. The association of n-3 polyunsaturated fatty acids with fatal ischemic heart disease, but not with nonfatal myocardial infarction, is consistent with possible antiarrhythmic effects of these fatty acids.
authors.affiliation: Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle 98101, USA. rozenl@u.washington.edu
authors.forename: Rozenn N
authors.initials: RN
authors.lastname: Lemaitre
authors.forename: Irena B
authors.initials: IB
authors.lastname: King
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality* / Q000517:prevention & control; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005395:Fish Oils; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D016017:Odds Ratio; D010743:Phospholipids / Q000097:blood* / Q000737:chemistry; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017962:alpha-Linolenic Acid / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D010743:Phospholipids; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid