Block Robert C, Harris William S, Reid Kimberly J, Sands Scott A, Spertus John A
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, Box 644, 601 Elmwood Avenue, NY 14642, United States. robert
Atherosclerosis. 2008 Apr;197(2):821-8. doi: 10.1016/j.atherosclerosis.2007.07.042. Epub 2007 Sep 17.
Increased blood levels of the omega-3 fatty acids (FA) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been inversely associated with risk for sudden cardiac death, but their relationship with acute coronary syndromes (ACS) is unclear.
We hypothesized that the EPA+DHA content of blood cell membranes, as a percent of total FAs, is reduced in ACS patients relative to matched controls.
We measured the content of EPA+DHA in 768 ACS patients and 768 age-, sex- and race-matched controls. The association with ACS case status of blood cell EPA+DHA [both by a 1 unit change and by category (low, <4%; intermediate 4.1-7.9%; and high, > or =8%)] was assessed using multivariate conditional logistic regression models adjusting for matching variables and smoking status, alcohol use, diabetes, body mass index, serum lipids, education, family history of coronary artery disease, personal histories of myocardial infarction and hypertension, and statin, aspirin, and other antiplatelet drug use.
The combined groups had a mean age of 61+/-12 years, 66% were male, and 92% were Caucasian. The EPA+DHA content was 20% lower in cases than controls (3.4+/-1.6 vs. 4.25+/-2.0%, p<0.001). The multivariable-adjusted odds for case status was 0.77 (95% CI 0.70 to 0.85, p<0.001) for a 1 unit increase in EPA+DHA content. Compared with the lowest EPA+DHA group, the odds ratio for an ACS event was 0.58 (95% CI 0.42-0.80), in the intermediate EPA+DHA group and was 0.31 (95% CI 0.14-0.67; p for trend <0.0001) in the highest EPA+DHA group.
Odds for ACS case status increased incrementally as the EPA+DHA content decreased suggesting that low EPA+DHA may be associated with increased risk for ACS.
血液中ω-3脂肪酸（FA）二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）水平升高与心源性猝死风险呈负相关，但其与急性冠状动脉综合征（ACS）的关系尚不清楚。
我们假设，相对于匹配的对照组，ACS患者血细胞细胞膜中EPA+DHA含量占总脂肪酸的百分比降低。
我们测量了768例ACS患者和768例年龄、性别和种族匹配的对照者的EPA+DHA含量。使用多变量条件逻辑回归模型评估血细胞EPA+DHA与ACS病例状态的关联[均以1个单位变化和类别（低，<4%；中，4.1-7.9%；高，≥8%）表示]，该模型对匹配变量和吸烟状况、饮酒、糖尿病、体重指数、血脂、教育程度、冠状动脉疾病家族史、心肌梗死和高血压个人史以及他汀类药物、阿司匹林和其他抗血小板药物的使用情况进行了调整。
合并组的平均年龄为61±12岁，66%为男性，92%为白种人。病例组的EPA+DHA含量比对照组低20%（3.4±1.6%对4.25±2.0%，p<0.001）。EPA+DHA含量每增加1个单位，病例状态的多变量调整比值比为0.77（95%CI 0.70至0.85，p<0.001）。与最低EPA+DHA组相比，ACS事件的比值比在中等EPA+DHA组为0.58（95%CI 0.42-0.80），在最高EPA+DHA组为0.31（95%CI 0.14-0.67；趋势p<0.0001）。
随着EPA+DHA含量降低，ACS病例状态的比值比逐渐增加，提示低EPA+DHA可能与ACS风险增加有关。
