title: Associations With Eicosapentaenoic Acid to Arachidonic Acid Ratio and Mortality in Hospitalized Heart Failure Patients.
abstract: BACKGROUND
  Intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) lowers the risk of atherosclerotic cardiovascular events, particularly ischemic heart disease. In addition, the ratio of eicosapentaenoic acid (EPA; n-3 PUFA) to arachidonic acid (AA; n-6 PUFA) has recently been recognized as a risk marker of cardiovascular disease. In contrast, the prognostic impact of the EPA/AA ratio on patients with heart failure (HF) remains unclear.
  
  
  RESULTS
  A total of 577 consecutive patients admitted for HF were divided into 2 groups based on median of the EPA/AA ratio: low EPA/AA (EPA/AA <0.32 mg/dl, n = 291) and high EPA/AA (EPA/AA ≥0.32, n = 286) groups. We compared laboratory data and echocardiographic findings and followed cardiac mortality. Although body mass index, blood pressure, B-type natriuretic peptide, hemoglobin, estimated glomerular filtration rate, total protein, albumin, sodium, C-reactive protein, and left ventricular ejection fraction did not differ between the 2 groups, cardiac mortality was significantly higher in the low EPA/AA group than in the high EPA/AA group (12.7 vs 5.9%, log-rank P = .004). Multivariate Cox proportional hazard analysis revealed that the EPA/AA ratio was an independent predictor of cardiac mortality (hazard ratio 0.677, 95% confidence interval 0.453-0.983, P = .041) in patients with HF.
  
  
  CONCLUSIONS
  The EPA/AA ratio was an independent predictor of cardiac mortality in patients with HF; therefore, the prognosis of patients with HF may be improved by taking appropriate management to control the EPA/AA balance.
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan. Electronic address: yoshihis@fmu.ac.jp.
authors.forename: Akiomi
authors.initials: A
authors.lastname: Yoshihisa
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kanno
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Takiguchi
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yokokawa
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Oikawa
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Shu-Ichi
authors.initials: SI
authors.lastname: Saitoh
authors.affiliation: Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016718:Arachidonic Acid / Q000097:blood*; D015118:Eicosapentaenoic Acid / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid
keywords: Heart failure; eicosapentaenoic acid to docosahexaenoic acid ratio; n-3 polyunsaturated fatty acids; prognosis