title: Impact of n-3 polyunsaturated fatty acids in predicting ischemia/reperfusion injury and progression of myocardial damage after reperfusion in patients with ST-segment elevation acute myocardial infarction.
abstract: BACKGROUND
  In animal models of acute myocardial infarction, n-3 polyunsaturated fatty acids (PUFAs) administered before coronary occlusion have been suggested to prevent induction of ventricular arrhythmia and limit infarct size. However, the relation between the serum levels of n-3 PUFAs and ischemia/reperfusion (I/R) injury remains unclear.
  
  
  METHODS
  211 patients with ST-segment elevation acute myocardial infarction received emergency percutaneous coronary intervention (PCI) within 6h from the onset. The patients were divided into two groups according to the sum of serum eicosapentaenoic acid (EPA) levels and docosahexaenoic acid (DHA) levels before PCI: group L (n=106), EPA+DHA <155μg/ml and group H (n=105), EPA+DHA ≥155μg/ml. The Selvester QRS-scoring system was used to estimate the serial change in infarct size.
  
  
  RESULTS
  Time to reperfusion was similar between the 2 groups. The QRS score before PCI was higher in group L than in group H (2.42±2.00 vs 1.85±2.01, p=0.015). The proportion of patients with I/R injury immediately after reperfusion, defined as reperfusion ventricular arrhythmias (25% vs 11%, p=0.006) and ST-segment re-elevation (44% vs 22%, p<0.001), was also higher in group L than in group H, followed by a greater increment in the QRS score during PCI (3.51±2.51 vs 2.54±1.91, p=0.006) and higher peak levels of creatinine phosphokinase (3552±241U/L vs 2660±242U/L, p<0.01). On multivariate analysis, serum level of EPA+DHA was an independent predictor of reperfusion injury (odds ratio 0.985, p=0.032).
  
  
  CONCLUSIONS
  Serum level of n-3 PUFAs before PCI may be a predictor of I/R injury and the resultant extent of myocardial damage. These findings suggest a protective effect of serum n-3 PUFAs on ischemic myocardium.
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan. Electronic address: hiroking@gamma.ocn.ne.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Arakawa
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Himeno
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Kirigaya
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Otomo
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Nakahashi
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Nitta
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yano
authors.affiliation: Division of Cardiology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Endo
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University, School of Medicine, Kanagawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging* / Q000209:etiology; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011859:Radiography; D013997:Time Factors
chemical_list: D015415:Biomarkers; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: Ischemia reperfusion injury; Myocardial infarction; n-3 polyunsaturated fatty acids