Abstract 13995: Decreased Circulating Omega-6 Fatty Acid Levels Are Associated With Total Mortality in Patients Admitted to Cardiac Intensive Care Unit

Abstract

Introduction: Polyunsaturated fatty acids (PUFAs), especially omega-3 fatty acids, have several important roles in the pathogenesis of cardiovascular diseases. Several studies have reported the anti-inflammatory and anti-atherogenic effects of omega-6 and omega-3 fatty acids. However, the clinical significance of PUFAs metabolism in the acute phase of cardiovascular diseases remains unknown. Therefore, we investigated the association between circulating PUFAs levels and clinical prognosis in patients admitted to the cardiac intensive care unit. Methods: We recruited 414 consecutive patients (acute decompensated heart failure: 36.0%, acute coronary syndrome: 38.4%) admitted to the cardiac intensive care unit in our University Hospital from April 2012 to October 2013. Fasting plasma PUFAs levels, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DGLA), were measured within 24 h after admission. After excluding patients with malignant diseases, end stage kidney disease, and received EPA therapy, 328 patients were followed up until December 2015. Results: During the 2.4 year mean follow-up period, 51 patients died. The levels of DGLA (31.3 ± 12.2 vs. 23.6 ± 11.3 μg/mL, P < 0.01) and AA (171.6 ± 51.9 vs. 147.8 ± 44.2 μg/mL, P < 0.01), but not EPA (53.6 ± 34.8 vs. 47.5 ± 26.4 μg/mL, NS) and DHA (127.2 ± 43.1 vs. 116.7 ± 36.4 μg/mL, NS), were significantly lower in the non-survivor group compared with the survivor group. Kaplan-Meier survival analysis showed that low DGLA, AA levels and DGLA/AA, but not EPA and DHA levels, were associated with all-cause mortality. Furthermore, Kaplan-Meier survival analysis showed that low DGLA, AA levels and DGLA/AA were associated with all-cause mortality in 114 patients with acute decompensated heart failure (ADHF), whereas each PUFAs levels were not significantly associated with all-cause mortality in 137 patients with acute coronary syndrome. Conclusion: Decreased levels of circulating DGLA and AA in patients admitted to the cardiac intensive care unit were significantly associated with total mortality, especially patients with ADHF. The present study showed it is possible DGLA levels predict long-term mortality.