Acute coronary syndrome patients with depression have low blood cell membrane omega-3 fatty acid levels.
OBJECTIVE
To determine the extent to which levels of membrane eicosapentaenoic (EPA)+docosahexaenoic acids (DHA) (the omega-3 index) were associated with depression in patients with acute coronary syndrome (ACS). Depression is associated with worse cardiovascular (CV) outcomes in patients with ACS. Reduced levels of blood cell membrane omega-3 (n-3) fatty acids (FAs), an emerging risk factor for both CV disease and depression, may help to explain the link between depression and adverse CV outcomes.


METHODS
We measured membrane FA composition in 759 patients with confirmed ACS. The analysis included not only EPA and DHA but also the n-6 FAs linoleic and arachidonic acids (LA and AA). Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ). Multivariable linear regression was used to adjust for demographic and clinical characteristics.


RESULTS
There was a significant inverse relationship between the n-3 index and depressive symptoms (PHQ) in the fully adjusted model (p = .034). For every 4.54% point rise in the n-3 index, there was a 1-point decline in depressive symptoms. In contrast to the n-3 FAs, membrane levels of the n-6 FAs LA and AA were not different between depressed and nondepressed ACS patients.


CONCLUSIONS
We found an inverse relationship between the n-3 index and the prevalence of depressive symptoms in patients with ACS. Therefore, this study supports the hypothesis that reduced n-3 FA tissue levels are a common and potentially modifiable link between depression and adverse CV outcomes.
Department of Cardiology, Mid America Heart Institute, Saint Luke' Hospital, Kansas City, Missouri, USA. aamin@saint-lukes.org
Alpesh A
AA
Amin
Rishi A
RA
Menon
Kimberly J
KJ
Reid
William S
WS
Harris
John A
JA
Spertus
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood; D016718:Arachidonic Acid / Q000097:blood; D015992:Body Mass Index; D002849:Chromatography, Gas; D015897:Comorbidity; D003866:Depressive Disorder / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D004910:Erythrocyte Membrane / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013223:Statistics as Topic
D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid