title: Free fatty acids are independently associated with all-cause and cardiovascular mortality in subjects with coronary artery disease.
abstract: BACKGROUND
  Free fatty acids (FFAs) are associated with several cardiovascular risk factors and exert harmful effects on the myocardium.
  
  
  OBJECTIVE
  The aim of our study was to elucidate the relationship between FFAs and mortality in subjects who underwent coronary angiography.
  
  
  METHODS
  Ludwigshafen Risk and Cardiovascular Health is a prospective cohort study of Caucasians who had undergone coronary angiography at baseline (1997-2000). During a median time of follow-up of 5.38 yr, 513 deaths had occurred among 3315 study participants with measured FFAs.
  
  
  METHODS
  Hazard ratios for mortality according to FFA levels were measured.
  
  
  RESULTS
  At the fourth quartile of FFAs, fully adjusted hazard ratios for death from any cause and cardiovascular causes were 1.58 (P = 0.002) and 1.83 (P = 0.001), respectively. In persons with angiographic coronary artery disease (CAD), stable CAD, and unstable CAD, the predictive value of FFAs was similar to that in the entire cohort, but the association did not attain statistical significance in persons without CAD analyzed separately. FFA levels were not related to the presence of angiographic CAD but were elevated in subjects with unstable CAD, compared with probands with stable CAD. Furthermore, FFAs increased with the severity of heart failure and were positively correlated with N-terminal pro-B-type natriuretic peptide (P < 0.001).
  
  
  CONCLUSIONS
  FFA levels independently predict all-cause and cardiovascular mortality in subjects with angiographic CAD. A possible diagnostic use of FFAs warrants further studies, but our results may underline the importance of therapeutic approaches to influence FFA metabolism.
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.forename: Hubert
authors.initials: H
authors.lastname: Scharnagl
authors.forename: Beate
authors.initials: B
authors.lastname: Tiran
authors.forename: Ursula
authors.initials: U
authors.lastname: Seelhorst
authors.forename: Britta
authors.initials: B
authors.lastname: Wellnitz
authors.forename: Bernhard O
authors.initials: BO
authors.lastname: Boehm
authors.forename: Jürgen R
authors.initials: JR
authors.lastname: Schaefer
authors.forename: Winfried
authors.initials: W
authors.lastname: März
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors
chemical_list: D005230:Fatty Acids, Nonesterified