title: Relation between red blood cell omega-3 fatty acid index and bleeding during acute myocardial infarction.
abstract: Omega-3 fatty acids have multiple cardiovascular benefits but may also inhibit platelet aggregation and increase bleeding risk. If this platelet inhibition is clinically meaningful, patients with the highest omega-3 indexes (red blood cell eicosapentaenoic acid plus docosahexaenoic acid), which reflect long-term omega-3 fatty acid intake, should be at the risk for bleeding. In this study, 1,523 patients from 24 United States centers who had their omega-3 indexes assessed at the time of acute myocardial infarction were studied. The rates of serious bleeding (Thrombolysis In Myocardial Infarction [TIMI] major or minor) and mild to moderate bleeding (TIMI minimal) were identified in patients with low (<4%), intermediate (4% to 8%), and high (>8%) omega-3 indices. There were no differences in bleeding across omega-3 index categories. After multivariate adjustment, there remained no association between the omega-3 index and either serious (per 2% increase, relative risk 1.03, 95% confidence interval 0.90 to 1.19) or mild to moderate bleeding (per 2% increase, relative risk 1.02, 95% confidence interval 0.85 to 1.23). In conclusion, no relation was found between the omega-3 index and bleeding in this large, multicenter cohort of patients with acute myocardial infarction, suggesting that concerns about bleeding should not preclude the use of omega-3 supplements or increased fish consumption when clinically indicated.
authors.affiliation: Saint Luke's Mid America Heart and Vascular Institute, Kansas City, Missouri, USA. salisburya@umkc.edu
authors.forename: Adam C
authors.initials: AC
authors.lastname: Salisbury
authors.forename: William S
authors.initials: WS
authors.lastname: Harris
authors.forename: Amit P
authors.initials: AP
authors.lastname: Amin
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Reid
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
mesh_terms: D002849:Chromatography, Gas; D019587:Dietary Supplements / Q000009:adverse effects*; D004912:Erythrocytes / Q000378:metabolism*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy; D010974:Platelet Aggregation / Q000187:drug effects; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015525:Fatty Acids, Omega-3