title: Elevated plasma free fatty acids are associated with sudden death: a prospective community-based evaluation at the time of cardiac arrest.
abstract: BACKGROUND
  In cohort studies, elevated levels of plasma nonesterified free fatty acids (NEFAs) have been associated with increased risk of sudden cardiac death (SCD) in men, but blood samples were drawn several years before SCD.
  
  
  OBJECTIVE
  To confirm this relationship by evaluating levels of plasma NEFAs at the time of the SCD event in a group of both men and women.
  
  
  METHODS
  From the ongoing Oregon Sudden Unexpected Death Study, we compared levels of plasma NEFAs in 149 SCD cases presenting with ventricular fibrillation (mean age 64 ± 12 years; 73% men) and 149 age- and sex-matched controls with coronary artery disease. Plasma was processed from blood drawn at the time of arrest (cases) and at a routine visit (controls). The levels of plasma NEFAs were compared after categorizing into quartiles on the basis of control values. Conditional logistic regression was used to predict adjusted odds ratio for SCD associated with plasma NEFA levels per increased quartile.
  
  
  RESULTS
  The plasma NEFA levels were significantly higher in SCD cases than in controls (median 0.39 mmol/L [interquartile range 0.28-0.60 mmol/L] vs 0.32 mmol/L [interquartile range 0.20-0.49 mmol/L]; P = .002). There were no significant differences in body mass index, smoking, and diabetes. The odds ratio for SCD was 1.42 (95% confidence interval 1.14-1.78) per quartile increase in the plasma NEFA level (P = .002). Individuals with plasma NEFA levels above the prespecified cutoff point of 0.32 mmol/L were at increased risk of SCD (odds ratio 2.00; 95% confidence interval 1.20-3.34; P = .008).
  
  
  CONCLUSIONS
  These findings strengthen the role of plasma NEFA as a potential biomarker for the assessment of SCD risk.
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Havmoeller
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Kyndaron
authors.initials: K
authors.lastname: Reinier
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Carmen
authors.initials: C
authors.lastname: Teodorescu
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Naser
authors.initials: N
authors.lastname: Ahmadi
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Kwok
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Audrey
authors.initials: A
authors.lastname: Uy-Evanado
authors.affiliation: Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Yii-Der I
authors.initials: YD
authors.lastname: Chen
authors.affiliation: Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Jerome I
authors.initials: JI
authors.lastname: Rotter
authors.affiliation: Department of Pathology, Oregon Health and Science University, Portland, Oregon.
authors.forename: Karen
authors.initials: K
authors.lastname: Gunson
authors.affiliation: Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jui
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: sumeet.chugh@cshs.org.
authors.forename: Sumeet S
authors.initials: SS
authors.lastname: Chugh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015415:Biomarkers / Q000097:blood; D003645:Death, Sudden; D016757:Death, Sudden, Cardiac; D004285:Dogs; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006323:Heart Arrest / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D005230:Fatty Acids, Nonesterified
keywords: Biomarker; Cardiac arrest; Fatty acids; Risk prediction; Sudden cardiac death