title: n-3 Fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease.
abstract: BACKGROUND
  Data on the association of n-3 fatty acid content in serum lipids with mortality in patients with coronary artery disease (CAD) are limited.
  
  
  OBJECTIVE
  We hypothesized that a high proportion of n-3 fatty acids in serum lipids would be associated with reduced risks of death and coronary events in patients with established CAD.
  
  
  METHODS
  We measured dietary intakes via food records and the fatty acid composition of serum cholesteryl esters (CEs) in 285 men and 130 women with CAD (x age: 61 y; range: 33-74 y). The patients participating in the EUROASPIRE (European Action on Secondary Prevention through Intervention to Reduce Events) study were followed up for 5 y.
  
  
  RESULTS
  During the follow-up, 36 patients died, 21 had myocardial infarctions, and 12 had strokes. The relative risks (RRs) of death adjusted for cardiovascular disease risk factors for subjects in the highest tertile of fatty acids in CEs compared with those in the lowest tertile were 0.33 (95% CI: 0.11, 0.96) for alpha-linolenic acid, 0.33 (0.12, 0.93) for eicosapentaenoic acid, and 0.31 (0.11, 0.87) for docosahexaenoic acid (P for trend = 0.063, 0.056, and 0.026, respectively). A high proportion of eicosapentaenoic acid in CEs was associated with a low risk of CAD death. Compared with no consumption, consumption of fish tended to be associated with a lower risk of death [1-57 g/d, RR = 0.50 (0.20, 1.28); > 57 g/d, RR = 0.37 (0.14, 1.00); P for trend = 0.059].
  
  
  CONCLUSIONS
  High proportions of n-3 fatty acids in serum lipids are associated with a substantially reduced risk of death.
authors.affiliation: Department of Clinical Nutrition, University of Kuopio and Kuopio University Hospital, Kuopio, Finland. arja.erkkila@tufts.edu
authors.forename: Arja T
authors.initials: AT
authors.lastname: Erkkilä
authors.forename: Seppo
authors.initials: S
authors.lastname: Lehto
authors.forename: Kalevi
authors.initials: K
authors.lastname: Pyörälä
authors.forename: Matti I J
authors.initials: MI
authors.lastname: Uusitupa
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology*; D002788:Cholesterol Esters / Q000097:blood; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality*; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011446:Prospective Studies; D012306:Risk; D020521:Stroke / Q000453:epidemiology; D017962:alpha-Linolenic Acid / Q000097:blood
chemical_list: D002788:Cholesterol Esters; D015525:Fatty Acids, Omega-3; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid