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血浆ω-3水平与新发心力衰竭及相关死亡率的关联

Association of Plasma Omega-3 Levels With Incident Heart Failure and Related Mortalities.

作者信息

Jawad Mohammad Abdel, O'Keefe James H, Tintle Nathan, O'Keefe Evan L, Franco W Grant, Djousse Luc, Ryder Nathan, Harris William S

机构信息

Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO.

Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO.

出版信息

Mayo Clin Proc. 2024 Dec;99(12):1895-1904. doi: 10.1016/j.mayocp.2024.08.007.

Abstract

OBJECTIVE

To investigate the association between plasma omega-3 levels and incident heart failure (HF) and to examine their relationship with total and cardiovascular (CV) mortality among patients with preexisting HF.

PATIENTS AND METHODS

The UK Biobank is an ongoing prospective cohort study of individuals recruited in the United Kingdom between April 1, 2007, and December 31. 2010. We used Cox proportional hazards models to predict incident HF in those without baseline HF and total and CV mortality in those with baseline HF, all as a function of baseline plasma omega-3 levels.

RESULTS

In participants without HF at baseline (n=271,794), a generally linear inverse association was observed between omega-3 levels and incident HF during a median follow-up of 13.7 years. The risk was 21% lower in the highest quintile of omega-3 compared with the lowest quintile (hazard ratio, 0.79; 95% CI, 0.74 to 0.84; P<.001) in multivariable models. In parallel models in participants with prevalent HF (n=1239), risk for all-cause and CV mortality were both reduced by approximately 50% comparing top to bottom omega-3 quintiles (hazard ratio, 0.53; 95% CI, 0.33 to 0.86; and hazard ratio, 0.50; 95% CI, 0.31 to 0.79, respectively; both P<.01).

CONCLUSION

Higher plasma levels of marine omega-3 fatty acids were associated with a lower incidence of HF. Furthermore, among patients with preexisting HF, higher omega-3 levels were associated with lower risks of all-cause mortality and CV mortality. These findings suggest that increasing plasma omega-3 levels, whether by diet or supplementation, could reduce both risk for development of HF and death in those with prevalent HF.

摘要

目的

研究血浆ω-3水平与新发心力衰竭(HF)之间的关联,并探讨其与已有HF患者的全因死亡率和心血管(CV)死亡率之间的关系。

患者与方法

英国生物银行是一项正在进行的前瞻性队列研究,研究对象为2007年4月1日至2010年12月31日在英国招募的个体。我们使用Cox比例风险模型来预测无基线HF者的新发HF以及有基线HF者的全因死亡率和CV死亡率,所有这些均作为基线血浆ω-3水平的函数。

结果

在基线时无HF的参与者(n = 271,794)中,在中位随访13.7年期间,观察到ω-3水平与新发HF之间存在大致线性的负相关。在多变量模型中,ω-3最高五分位数组的风险比最低五分位数组低21%(风险比,0.79;95%可信区间,0.74至0.84;P <.001)。在患有HF的参与者(n = 1239)的平行模型中,比较ω-3最高和最低五分位数组,全因死亡率和CV死亡率的风险均降低了约50%(风险比分别为0.53;95%可信区间,0.33至0.86;以及风险比,0.50;95%可信区间,0.31至0.79;两者P <.01)。

结论

较高的血浆海洋ω-3脂肪酸水平与较低的HF发病率相关。此外,在已有HF的患者中,较高的ω-3水平与较低的全因死亡率和CV死亡率风险相关。这些发现表明,通过饮食或补充剂提高血浆ω-3水平,可降低HF发生风险以及已有HF患者的死亡风险。

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