title: Which has the stronger impact on coronary artery disease, eicosapentaenoic acid or docosahexaenoic acid?
abstract: It has been suggested that n-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), protect against cardiovascular diseases, and EPA/arachidonic acid (AA) and DHA/AA ratios in serum are potential risk markers for coronary artery disease (CAD). The purpose of this study was to clarify the clinical significance of the difference in the EPA/AA ratio and the DHA/AA ratio in patients with CAD. In 369 patients with confirmed or suspected CAD who underwent diagnostic coronary angiography, we measured serum levels of EPA, DHA and AA and calculated the EPA/AA and DHA/AA ratios. The EPA/AA ratio was significantly lower in patients with acute coronary syndrome (ACS) than in patients with chronic CAD or chest pain syndrome (0.27±0.19 vs. 0.44±0.20, respectively; P<0.01), whereas the DHA/AA ratio was similar in the two groups (0.78±0.27 vs. 0.79±0.37). Multiple logistic regression analyses using various biomarkers related to coronary risk discriminated ACS from other disease entities and demonstrated that the EPA/AA ratio (odds ratio: 0.0012, 95% confidence interval: 0.00-0.16, P<0.01) but not the DHA/AA ratio (odds ratio: 1.05, 95% confidence interval: 0.98-1.12) was a significant independent predictive factor. Our findings suggest that the EPA/AA ratio might be more closely associated with the pathophysiology of CAD, especially with that of ACS, than the DHA/AA ratio. Our findings suggest that interventions with EPA agents or supplemental EPA intake, compared with DHA agents or supplemental DHA, may confer greater benefit for plaque stabilization to prevent the onset of ACS in patients with CAD.
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Iwamatsu
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Shichiro
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishida
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kageyama
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Nasuno
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakuma
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Toyoda
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D016718:Arachidonic Acid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D004281:Docosahexaenoic Acids / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid