Circulating Omega-6, But Not Omega-3 Polyunsaturated Fatty Acids, Are Associated with Clinical Outcomes in Patients with Acute Decompensated Heart Failure.
BACKGROUND
Circulating polyunsaturated fatty acid (PUFA) levels are associated with clinical outcomes in cardiovascular diseases including coronary artery disease and chronic heart failure (HF). However, their clinical implications in acute decompensated HF (ADHF) remain unclear. The aim of this study was to investigate the clinical roles of circulating PUFAs in patients with ADHF.


METHODS
Circulating levels of PUFAs, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA) and dihomo-gamma linoleic acid (DGLA), were measured on admission in 685 consecutive ADHF patients. Adverse events were defined as all-cause death and worsening HF.


RESULTS
During a median follow-up period of 560 days, 262 (38.2%) patients had adverse events. Although patients with adverse events had lower n-6 PUFA (AA + DGLA) level than those without, n-3 PUFA (EPA + DHA) level was comparable between the groups. Kaplan-Meier analyses showed that lower n-6 PUFA level on admission was significantly associated with the composite of all-cause death and worsening HF, all-cause death, cardiovascular death and worsening HF (p < 0.001, p = 0.005, p = 0.021, p = 0.019, respectively). In a multivariate Cox model, lower n-6 PUFA level was independently associated with increased risk of adverse events (HR 0.996, 95% CI: 0.993-0.999, p = 0.027).


CONCLUSIONS
Lower n-6 but not n-3 PUFA level on admission was significantly related to worse clinical outcomes in ADHF patients. Measurement of circulating n-6 PUFA levels on admission might provide information for identifying high risk ADHF patients.
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Toshiyuki
T
Nagai
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Yasuyuki
Y
Honda
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Yasuo
Y
Sugano
Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan.
Kunihiro
K
Nishimura
Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan.
Michikazu
M
Nakai
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Satoshi
S
Honda
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Naotsugu
N
Iwakami
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Atsushi
A
Okada
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Yasuhide
Y
Asaumi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Takeshi
T
Aiba
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Teruo
T
Noguchi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Kengo
K
Kusano
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Hisao
H
Ogawa
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Satoshi
S
Yasuda
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Toshihisa
T
Anzai
D015126:8,11,14-Eicosatrienoic Acid / Q000097:blood; D000208:Acute Disease; D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid; D015126:8,11,14-Eicosatrienoic Acid