title: Relationships between plasma fatty acid composition and coronary artery disease.
abstract: OBJECTIVE
  The Japan EPA Lipid Intervention Study (JELIS) was the first prospective randomized clinical trial to demonstrate prevention of coronary events by pure eicosapentaenoic acid (EPA). The aim of this study was to examine the relationships between various plasma fatty acid concentrations and the risk of coronary events in JELIS participants.
  
  
  METHODS
  In 15,534 participants, we calculated the hazard ratio for major coronary events (sudden cardiac death, fatal or nonfatal myocardial infarction, unstable angina pectoris, and angioplasty/stenting or coronary artery bypass grafting) relative to the on-treatment average level of plasma fatty acids with the Cox proportional hazard model.
  
  
  RESULTS
  As a result of EPA intervention, the plasma EPA concentration increased, but the docosahexaenoic acid (DHA) concentration did not. The other fatty acids measured decreased slightly. The higher plasma level of EPA (hazard ratio=0.83, p=0.049, in all participants and hazard ratio=0.71, p=0.018, in the EPA intervention group), but not of DHA, was inversely associated with the risk of major coronary events. The associations between other fatty acids and the risk of major coronary events were not significant. In all JELIS participants, the risk of major coronary events was significantly decreased (20%) in the group with high (150 µg/mL or more) on-treatment plasma EPA concentration compared with that in the low (less than 87 µg/mL) group.
  
  
  CONCLUSIONS
  The risk of coronary artery disease is influenced by variations in plasma fatty acid composition. Among n-3 polyunsaturated fatty acids, EPA and DHA exhibited differences in the correlation with the risk of major coronary events.
authors.affiliation: Shinagawa East One Medical Clinic, Tokyo, Japan. shinagawa-east-one@jouzenkai.or.jp
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Itakura
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Sasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
authors.forename: Toru
authors.initials: T
authors.lastname: Kita
authors.forename: Akira
authors.initials: A
authors.lastname: Kitabatake
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakaya
authors.forename: Toshiie
authors.initials: T
authors.lastname: Sakata
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Kunio
authors.initials: K
authors.lastname: Shirato
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood* / Q000209:etiology* / Q000517:prevention & control; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood / Q000494:pharmacology; D005227:Fatty Acids / Q000097:blood* / Q000737:chemistry*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D005227:Fatty Acids; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid