title: Relationship between coronary plaque vulnerability and serum n-3/n-6 polyunsaturated fatty acid ratio.
abstract: BACKGROUND
  A low ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) has been associated with cardiovascular events. Higher-grade yellow color coronary plaques are associated with higher plaque vulnerability and higher thrombogenic potential. Therefore, the association between EPA/AA ratio and yellow color grade of coronary plaques was examined.
  
  
  RESULTS
  Consecutive patients (n=54) who underwent percutaneous coronary intervention were enrolled in this study. The serum EPA/AA ratio was examined on admission. All patients underwent an angioscopic examination of the culprit vessel to examine the color grade of yellow plaques (0, white; 1, slight yellow; 2, yellow; and 3, intense yellow) and the presence of thrombus. Excluding 16 patients with acute coronary syndrome (ACS), 38 patients with stable angina were divided into 2 groups according to their EPA/AA ratio: the low EPA/AA group (n=19, EPA/AA ratio <0.37 [median]) and the high EPA/AA group (n=19, EPA/AA ratio ≥0.37). The maximum color grade (2.5 ± 0.5 vs. 1.9 ± 0.9; P=0.01) of yellow plaques was significantly higher and the number of non-culprit yellow plaques with thrombus (1.7 ± 0.8 vs. 1.2 ± 1.1; P=0.06) tended to be higher in low EPA/AA than in high EPA/AA stable angina patients. Multivariate analysis revealed that the serum EPA level (odds ratio=0.98, 95% confidence interval=0.96-0.99, P=0.03) was associated with the presence of grade-3 yellow plaques.
  
  
  CONCLUSIONS
  A low serum EPA level and a low EPA/AA ratio was associated with high vulnerability of coronary plaques.
authors.affiliation: Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kashiyama
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nemoto
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Wada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Masumura
authors.forename: Koshi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Mayu
authors.initials: M
authors.lastname: Nishio
authors.forename: Akio
authors.initials: A
authors.lastname: Hirata
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Asai
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kashiwase
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kodama
mesh_terms: D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D003116:Color; D003328:Coronary Thrombosis / Q000209:etiology / Q000473:pathology; D004198:Disease Susceptibility; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000473:pathology*
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid