title: Low serum eicosapentaenoic acid level is a risk for ventricular arrhythmia in patients with acute myocardial infarction: a possible link to J-waves.
abstract: Eicosapentaenoic acid (EPA) has antiarrhythmic effects. The J-wave on an electrocardiogram is associated with a high incidence of ventricular tachycardia/fibrillation (VT/VF). We evaluated relationships between EPA and J-waves, and their involvement in the occurrence of VT/VF in acute myocardial infarction (AMI). Two hundred consecutive patients undergoing successful percutaneous coronary intervention within 12 h after AMI onset were enrolled. Serum EPA level and J-waves at admission were evaluated. The patients were divided into two groups according to the optimal cutoff value (2.94) of serum EPA level (% of total fatty acids): LOW (<2.94, 61 ± 11 years, n = 103) and HIGH groups (≥2.94, 70 ± 13 years, n = 81). J-waves were observed more frequently in the LOW (36/103, 35 %) than in HIGH group (16/81, 20 %) (P = 0.020). The 30-day incidence of VT/VF including those occurring before admission was higher in the LOW (19.5 %) than in HIGH group (6.2 %) (P = 0.009). The patients with J-waves showed a higher incidence of VT/VF (23.1 %) than those without J-waves (9.9 %) (P = 0.019). Kaplan-Meier analysis showed that the highest incidence of VT/VF was observed in the LOW with J-wave group (27.8 %), followed by the LOW without J-wave (15.0 %), HIGH with J-wave (12.5 %), and HIGH without J-wave (4.6 %) (P = 0.013). Cox proportional hazard analysis revealed that Killip grade and low serum EPA level or presence of J-waves were significantly associated with the incidence of VT/VF. Low serum EPA level is a risk for incidence of VT/VF in the acute phase of myocardial infarction. Involvement of the J-wave and its possible link with EPA in the pathogenesis of ischemia-induced VT/VF are suggested.
authors.affiliation: Department of Cardiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Endo
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomita
authors.forename: Takumi
authors.initials: T
authors.lastname: Higuma
authors.forename: Naoki
authors.initials: N
authors.lastname: Abe
authors.forename: Motoi
authors.initials: M
authors.lastname: Kushibiki
authors.forename: Shin
authors.initials: S
authors.lastname: Saitoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamada
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokota
authors.forename: Takashi
authors.initials: T
authors.lastname: Echizen
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Shunta
authors.initials: S
authors.lastname: Tateyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishida
authors.forename: Kazuo
authors.initials: K
authors.lastname: Murakami
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osanai
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002317:Cardiovascular Agents / Q000097:blood / Q000627:therapeutic use; D015118:Eicosapentaenoic Acid / Q000097:blood / Q000627:therapeutic use; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000097:blood / Q000209:etiology / Q000517:prevention & control
chemical_list: D002317:Cardiovascular Agents; D015118:Eicosapentaenoic Acid