title: Plasma α-Linolenic and Long-Chain ω-3 Fatty Acids Are Associated with a Lower Risk of Acute Myocardial Infarction in Singapore Chinese Adults.
abstract: BACKGROUND
  Long-chain marine omega-3 polyunsaturated fatty acids (n-3 PUFAs) are associated with a lower risk of acute myocardial infarction (AMI), but results for plant-derived α-linolenic acid (ALA; 18:3n-3) are inconsistent.
  
  
  OBJECTIVE
  We aimed to examine the association between plasma n-3 PUFAs and AMI risk and to explore potential mediation by cardiovascular disease risk factors.
  
  
  METHODS
  A nested case-control study with 744 incident AMI cases and 744 matched controls was conducted within the Singapore Chinese Health Study for participants aged 47-83 y. Conditional logistic regression was used to calculate the multivariable ORs for AMI with and without adjustment for cardiovascular disease risk factors, including blood lipids, blood pressure, C-reactive protein, serum creatinine, and glycated hemoglobin.
  
  
  RESULTS
  Plasma long-chain n-3 PUFAs were associated with lower AMI risk (multivariable OR: 0.62; 95% CI: 0.41, 0.94; for the highest compared with the lowest quartile; P-trend = 0.03). This association was not substantially changed after adjustment for cardiovascular disease risk factors. Dietary intakes of fish and long-chain n-3 PUFAs were similarly inversely associated with AMI risk. Plasma ALA was marginally associated with a lower risk of AMI (multivariable OR: 0.73; 95% CI: 0.51, 1.05; P-trend = 0.07) even in persons with high plasma concentrations of long-chain n-3 PUFAs. This association became significantly weaker after adjustment for blood pressure and LDL cholesterol.
  
  
  CONCLUSIONS
  Plasma long-chain n-3 PUFAs are associated with a lower risk of AMI in this Asian population. Plasma ALA may be marginally associated with reduced AMI risk, even in persons with high concentrations of long-chain n-3 PUFAs, and this association may be partially mediated by lower blood pressure and LDL cholesterol.
authors.affiliation: Saw Swee Hock School of Public Health, and NUS Graduate School for Integrative Sciences and Engineering, and.
authors.forename: Ye
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Saw Swee Hock School of Public Health, and Duke-NUS Graduate Medical School Singapore, Singapore;
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; and.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Saw Swee Hock School of Public Health, and.
authors.forename: Hyungwon
authors.initials: H
authors.lastname: Choi
authors.affiliation: Saw Swee Hock School of Public Health, and.
authors.forename: Jin
authors.initials: J
authors.lastname: Su
authors.affiliation: Saw Swee Hock School of Public Health, and NUS Environmental Research Institute, National University of Singapore, Singapore;
authors.forename: Choon Nam
authors.initials: CN
authors.lastname: Ong
authors.affiliation: Saw Swee Hock School of Public Health, and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS) and National University Health System, Singapore; NUS Graduate School for Integrative Sciences and Engineering, and Department of Nutrition, Harvard School of Public Health, Boston, MA rob_martinus_van_dam@nuhs.edu.sg.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
mesh_terms: D000368:Aged; D044466:Asian People; D001794:Blood Pressure; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology / Q000517:prevention & control*; D016017:Odds Ratio; D012307:Risk Factors; D017747:Seafood; D012846:Singapore; D017962:alpha-Linolenic Acid / Q000097:blood* / Q000627:therapeutic use
chemical_list: D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D017962:alpha-Linolenic Acid
keywords: biomarkers; cardiovascular disease risk factors; diet; epidemiology; fatty acids; myocardial infarction; nutrition