Baseline plasma fatty acids profile and incident cardiovascular events in the SU.FOL.OM3 trial: the evidence revisited.
OBJECTIVE
We aimed to investigate the association between baseline plasma fatty acids profile and the risk of future major cardiovascular events in patients with a history of ischaemic heart disease or ischemic stroke.


METHODS
Baseline plasma fatty acids as well as established cardiovascular risk factors were measured in 2,263 patients enrolled in the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids randomized controlled trial. Incident major cardiovascular, cardiac and cerebrovascular events were ascertained during the 4.7 years of follow up. Hazard ratios were obtained from Cox proportional hazards models after adjustment for cardiovascular risk factors.


RESULTS
During the follow-up, 154, 379 and 84 patients had major cardiovascular, cardiac and cerebrovascular events respectively. Upon adjustment for gender, initial event, baseline age and BMI, the risk of developing a major cardiovascular event decreased significantly in successive quartiles of arachidonic acid (P trend<0.002), total omega 3 polyunsaturated fatty acids (P trend<0.03), docosapentaenoic acid (P trend<0.019), docosahexaenoic acid (P trend<0.004), eicosapentaenoic acid + docosahexaenoic acid (P trend<0.03) and eicosapentaenoic acid + docosapentaenoic acid + docosahexaenoic acid (P trend<0.02). This inverse association was borderline significant with increased quartiles of stearidonic acid (P trend<0.06). In the full model, only stearidonic acid remained inversely associated with the risk of developing a major cardiovascular event (P trend<0.035), a cardiac event (P trend<0.016) or a cerebrovascular event (P trend<0.014), while arachidonic acid was inversely associated with the risk a cerebrovascular event (P trend<0.033).


CONCLUSIONS
The inverse association of long chain omega 3 polyunsaturated fatty acids with recurrence of Cardiovascular diseases was mainly driven by well-known cardiovascular risk factors.


BACKGROUND
Controlled-Trials.com ISRCTN41926726.
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
Léopold K
LK
Fezeu
Département de Biochimie-Pharmacologie-Toxicologie, Centre Hospitalier Universitaire, Grenoble, France.
François
F
Laporte
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
Emmanuelle
E
Kesse-Guyot
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
Valentina A
VA
Andreeva
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France; Université Paris-Descartes, Faculté de Médecine, AP-HP; Hôtel-Dieu, Centre de Diagnostic et Thérapeutique, Paris, France.
Jacques
J
Blacher
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France; Département de Santé publique, Hôpital Avicenne, Bobigny, France.
Serge
S
Hercberg
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
Pilar
P
Galan
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology; D019587:Dietary Supplements; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology; D014803:Vitamin B Complex / Q000008:administration & dosage
D005231:Fatty Acids, Unsaturated; D014803:Vitamin B Complex