Department of Coronary Disease and HeartFailure, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
John Paul II Hospital, Kraków, Poland
Kardiol Pol. 2019 Oct 25;77(10):935-943. doi: 10.33963/KP.14923. Epub 2019 Aug 5.
Recent improvements in optimal cardiovascular therapy have questioned the beneficial effects of polyunsaturated fatty acids (PUFAs) observed in previous studies.
We investigated the fatty acid (FA) composition in serum phospholipids in patients with an established acute phase of myocardial infarction (MI) and in high‑risk patients with stable atherosclerotic cardiovascular disease (CVD).
We studied 83 patients hospitalized within 12 hours from the onset of the first clinical symptoms of MI. As a control group, we assessed 74 patients at high cardiovascular risk with an established stable atherosclerotic CVD treated at an outpatient cardiology clinic. Gas chromatography was used to evaluate the FA composition in serum phospholipids in both groups.
The final analysis included 52 patients with acute MI and 74 controls. In both groups, saturated FAs constituted the largest fraction of serum phospholipid FAs (median, 1574.67 μmol/l), followed by n‑6 PUFAs (median, 1106.99 μmol/l). The levels of total saturated FAs, monounsaturated FAs, n‑6 PUFAs, as well as the ratio of n‑6 to n‑3 PUFAs significantly differed between groups. Palmitic acid constituted the largest fraction of serum phospholipids both in patients and controls (31.9% and 31.16%, respectively). In a multivariate logistic regression analysis, body mass index, low‑density lipoprotein cholesterol, aspartate aminotransferase, high‑sensitivity C‑reactive protein, and palmitoleic and eicosadienoic acids were independently associated with MI.
We showed major differences in the FA composition of serum phospholipids between patients with acute MI and high‑risk individuals with stable atherosclerotic CVD. Eicosadienoic and palmitoleic acids, apart from typical cardiovascular risk factors, were independently associated with MI.
最近心血管治疗的优化改进使人们对之前研究中观察到的多不饱和脂肪酸(PUFA)的有益效果产生了质疑。
我们研究了急性心肌梗死(MI)发作 12 小时内住院的患者以及患有稳定动脉粥样硬化性心血管疾病(CVD)的高危患者的血清磷脂中的脂肪酸(FA)组成。
我们研究了 83 例 MI 首发临床症状发作 12 小时内住院的患者。作为对照组,我们评估了在心血管门诊就诊的 74 例有明确稳定动脉粥样硬化性 CVD 的高危患者。使用气相色谱法评估两组患者血清磷脂中的 FA 组成。
最终分析包括 52 例急性 MI 患者和 74 例对照组患者。在两组中,饱和 FA 构成血清磷脂 FA 中最大的部分(中位数,1574.67 μmol/L),其次是 n-6 PUFA(中位数,1106.99 μmol/L)。两组之间总饱和 FA、单不饱和 FA、n-6 PUFA 的水平以及 n-6 与 n-3 PUFA 的比值均有显著差异。棕榈酸在患者和对照组的血清磷脂中均占最大比例(分别为 31.9%和 31.16%)。在多变量逻辑回归分析中,体质指数、低密度脂蛋白胆固醇、天冬氨酸氨基转移酶、高敏 C 反应蛋白以及棕榈油酸和二十碳二烯酸与 MI 独立相关。
我们显示了急性 MI 患者与患有稳定动脉粥样硬化性 CVD 的高危个体之间血清磷脂 FA 组成的主要差异。除了典型的心血管危险因素外,二十碳二烯酸和棕榈油酸与 MI 独立相关。