title: Serum concentration of eicosapentaenoic acid is associated with cognitive function in patients with coronary artery disease.
abstract: BACKGROUND
  Recent studies have shown that intake of n-3 polyunsaturated fatty acids (PUFAs) is associated with reduced risk of cognitive impairment and coronary artery disease (CAD); however, it is currently unknown whether reduced serum n-3 PUFA is associated with cognitive impairment in patients with CAD.
  
  
  METHODS
  We retrospectively evaluated cognitive function with the mini-mental state examination (MMSE), serum levels of PUFAs (including eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], dihomogammalinolenic acid [DGLA], and arachidonic acid [AA]), cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, cerebrovascular disease, and history of current/previous smoking), and parameters of cardiac function (left ventricular ejection fraction and brain natriuretic peptide levels) in 146 Japanese CAD patients. The associations between the MMSE scores and the other parameters were evaluated.
  
  
  RESULTS
  Pearson correlation analysis showed that EPA (R = 0.25, P <0.01), EPA/AA ratio (R = 0.22, P = 0.01), and left ventricular ejection fraction (R = 0.15, P = 0.04) were positively associated with MMSE score, and that age (R = -0.20, P <0.01) and brain natriuretic peptide levels (R = -0.28, P <0.01) were inversely associated with MMSE score. Multiple regression analysis showed that age (P <0.05) was negatively associated with MMSE score, while EPA (P <0.01) and EPA/AA ratio (P <0.05) were positively associated with MMSE score; however, sex; body mass index; left ventricular ejection fraction; levels of DHA, AA, and DGLA; DHA/AA ratio; brain natriuretic peptide; and presence of hypertension, dyslipidemia, diabetes mellitus, cerebrovascular disease, and history of current/previous smoking were statistically excluded.
  
  
  CONCLUSIONS
  Serum EPA concentration is associated with cognitive function in patients with CAD, suggesting that a low serum EPA level is a risk factor for cognitive impairment independent of cardiac function, including left ventricular ejection fraction. This correlation potentially lends further support to a role of dietary n-3 PUFAs in preventing the cognitive decline in CAD patients.
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. syagi@tokushima-u.ac.jp.
authors.forename: Shusuke
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. tomoyahara@tokushima-u.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. linda_s610105@yahoo.co.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Ueno
authors.affiliation: Department of Medicine and Bioregulatory Sciences, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. aihara@tokushima-u.ac.jp.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Aihara
authors.affiliation: Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. daiju.fukuda@tokushima-u.ac.jp.
authors.forename: Daiju
authors.initials: D
authors.lastname: Fukuda
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. takashima-a@tokushima-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Takashima
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. jhotchi@tokushima-u.ac.jp.
authors.forename: Junko
authors.initials: J
authors.lastname: Hotchi
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. isetaka@tokushima-u.ac.jp.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ise
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. yamakoji3@tokushima-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. tobiume.takeshi@tokushima-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tobiume
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. iwasetaka@tokushima-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. yamadah@tokushima-u.ac.jp.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. soeki@tokushima-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soeki
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. wakatsukitz@tokushima-u.ac.jp.
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Wakatsuki
authors.affiliation: Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. mshimabukuro-ur@umin.ac.jp.
authors.forename: Michio
authors.initials: M
authors.lastname: Shimabukuro
authors.affiliation: Department of Medical Education, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. akaike.masashi@tokushima-u.ac.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Akaike
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, 3-18-15 Kuramoto-cho, Tokushima-city, Tokushima, 770-8503, Japan. masataka.sata@tokushima-u.ac.jp.
authors.forename: Masataka
authors.initials: M
authors.lastname: Sata
mesh_terms: D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood / Q000517:prevention & control; D003327:Coronary Disease / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume
chemical_list: D015525:Fatty Acids, Omega-3; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid