EPA and DHA in blood cell membranes from acute coronary syndrome patients and controls.
BACKGROUND
Increased blood levels of the omega-3 fatty acids (FA) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been inversely associated with risk for sudden cardiac death, but their relationship with acute coronary syndromes (ACS) is unclear.


OBJECTIVE
We hypothesized that the EPA+DHA content of blood cell membranes, as a percent of total FAs, is reduced in ACS patients relative to matched controls.


METHODS
We measured the content of EPA+DHA in 768 ACS patients and 768 age-, sex- and race-matched controls. The association with ACS case status of blood cell EPA+DHA [both by a 1 unit change and by category (low, <4%; intermediate 4.1-7.9%; and high, > or =8%)] was assessed using multivariate conditional logistic regression models adjusting for matching variables and smoking status, alcohol use, diabetes, body mass index, serum lipids, education, family history of coronary artery disease, personal histories of myocardial infarction and hypertension, and statin, aspirin, and other antiplatelet drug use.


RESULTS
The combined groups had a mean age of 61+/-12 years, 66% were male, and 92% were Caucasian. The EPA+DHA content was 20% lower in cases than controls (3.4+/-1.6 vs. 4.25+/-2.0%, p<0.001). The multivariable-adjusted odds for case status was 0.77 (95% CI 0.70 to 0.85, p<0.001) for a 1 unit increase in EPA+DHA content. Compared with the lowest EPA+DHA group, the odds ratio for an ACS event was 0.58 (95% CI 0.42-0.80), in the intermediate EPA+DHA group and was 0.31 (95% CI 0.14-0.67; p for trend <0.0001) in the highest EPA+DHA group.


CONCLUSIONS
Odds for ACS case status increased incrementally as the EPA+DHA content decreased suggesting that low EPA+DHA may be associated with increased risk for ACS.
Block
Robert C
RC
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, Box 644, 601 Elmwood Avenue, NY 14642, United States. robert block@urmc.rochester.edu
Harris
William S
WS
Reid
Kimberly J
KJ
Sands
Scott A
SA
Spertus
John A
JA
D054058:Acute Coronary Syndrome / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004281:Docosahexaenoic Acids / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D004910:Erythrocyte Membrane / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio
D015415:Biomarkers; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid