title: Omega-3 index and smoking in patients with acute ST-elevation myocardial infarction taking statins: a case-control study in Korea.
abstract: BACKGROUND
  n-3 fatty acids and lifestyle also are closely related to risk of CVD. Most Koreans have higher fish consumption than people of Western populations. However, little is known about the recommended value of omega-3 index in Korean patients with acute ST-elevation myocardial infarction (STEMI) taking statins. Here, we tested the hypothesis that lower omega-3 fatty acids and/or smoking are associated with acute STEMI, even though patients with dyslipidemia who were taking statins and who attained their LDL-C goals.
  
  
  METHODS
  We conducted a case-control study in which omega-3 fatty acids and lifestyle factors were determined in 24 consecutive Korean patients taking statins with angiographically confirmed acute STEMI and 68 healthy controls without acute STEMI. The omega-3 index was calculated by the sum of eicosapentaenoic acid and docosahexaenoic acid in erythrocyte membranes. Multivariable adjusted regression analysis was used to assess independent associations between acute STEMI, omega-3 index, and lifestyle factors after adjusting for age, sex, and body mass index (BMI).
  
  
  RESULTS
  The mean age of total subjects was 59.9 years, and 57.6% of the subjects were male. The omega-3 index was significantly lower in cases (8.83%) than controls (11.13%; P < 0.001); however, total trans-fatty acids were not different between the two groups. The omega-3 index was inversely associated with odds for being a case (OR 0.16 (95% CI 0.03-1.14); P = 0.047), while smoking was positively associated with odds for being a case (OR 6.67 (95% CI 1.77-25.23); P = 0.005) after adjusting for all confounding variables.
  
  
  CONCLUSIONS
  This study shows that relative to controls, acute STEMI cases are more likely to be smokers and to have a lower omega-3 index, even though the cases were taking statins. An omega-3 index of at least 11% and abstinence from smoking are associated with cardioprotection for Koreans.
authors.affiliation: Department of Family Medicine, Pusan National University Hospital, Busan, South Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Jeong
authors.forename: Jeong Gyu
authors.initials: JG
authors.lastname: Lee
authors.forename: Han Cheol
authors.initials: HC
authors.lastname: Lee
authors.forename: Sang Yeoup
authors.initials: SY
authors.lastname: Lee
authors.forename: Yun Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yu Hyeon
authors.initials: YH
authors.lastname: Yi
authors.forename: Yong Soon
authors.initials: YS
authors.lastname: Park
authors.forename: Young Hye
authors.initials: YH
authors.lastname: Cho
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Bae
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Choi
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D016022:Case-Control Studies; D002462:Cell Membrane / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000209:etiology / Q000378:metabolism; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D004562:Electrocardiography; D004912:Erythrocytes / Q000378:metabolism; D005227:Fatty Acids / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000378:metabolism*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D012307:Risk Factors; D012907:Smoking
chemical_list: D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors