title: Low levels of serum n-3 polyunsaturated fatty acids are associated with worse heart failure-free survival in patients after acute myocardial infarction.
abstract: BACKGROUND
  Intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFA), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), is associated with a lower risk of atherosclerotic cardiovascular events, particularly acute myocardial infarction (AMI). However, limited data are available regarding the association between serum n-3 PUFA levels and heart failure (HF) events in survivors of AMI.
  
  
  RESULTS
  We evaluated whether serum DHA and EPA levels were associated with HF-free survival and HF hospitalization rates after AMI. A total of 712 patients were divided into 3 groups according to their tertile serum levels of DHA and EPA (Low, Middle, and High). Propensity-score-stratified Cox regression analysis revealed that DHA- and EPA-Low groups presented statistically significant worse HF-free survival (hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.03-2.72, P=0.0358, and HR 1.69, 95% CI 1.05-2.72, P=0.0280, respectively), with the EPA-Low group having a higher risk of HF hospitalization (HR 2.40, 95% CI 1.21-4.75, P=0.0097) than the DHA-Low group (HR 1.72, 95% CI 0.86-3.45, P=0.1224). The relationship between a low DHA or EPA level and decreased HF-free survival was almost common to all subgroups; however, the effect of low serum EPA on HF hospitalization was prominent in male patients, and those with low levels of high-density lipoprotein cholesterol or without statin therapy.
  
  
  CONCLUSIONS
  Low levels of circulating n-3 PUFA are associated with decreased HF-free survival in post-AMI patients.
authors.affiliation: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hara
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakatani
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Suna
authors.forename: Masaya
authors.initials: M
authors.lastname: Usami
authors.forename: Sen
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Doi
authors.forename: Masami
authors.initials: M
authors.lastname: Nishino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D004281:Docosahexaenoic Acids / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000401:mortality; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid