Abstract 15530: Omega-3 Fatty acids Supplementation Attenuates the Progression of Microalbuminuria in Diabetics With Coronary Artery Disease

Abstract

Introduction: Microalbuminuria is a marker of generalized endothelial dysfunction, a key step in the pathogenesis of coronary artery disease (CAD). It is also an independent predictor of cardiovascular morbidity and mortality. Angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy is considered a standard of care to attenuate progression of albuminuria in diabetic patients. Hypothesis: Omega-3 fatty acids (FAs) supplementation will attenuate progression of microalbuminuria in diabetic subjects with stable CAD. Method: In our study, 262 subjects with stable CAD were randomized to 3.6 g of omega-3 FAs (1.86 g of eicosapentaenoic acid + 1.5 g of docosahexaenoic acid) per day or no omega-3 FA (control) for one year. Urine microalbumin to creatinine ratio (urine MCR mg/g) was calculated as a measure of microalbuminuria at baseline and one year follow-up. Results: Mean age was 63.3 ± 7.6 yrs, 17% were women, 30% had diabetes, and 74% were on ACEI or ARB therapy. At one year follow-up in non-diabetics, there was no significant difference in the % change in urine MCR between the omega-3 FAs and control groups (see table). In contrast in diabetics, those not receiving omega-3 FAs had a significant 72.3% increase in urine MCR whereas those receiving omega-3 FAs had no change (table). In subgroup analysis, diabetics on an ACEI or ARB receiving omega-3 FAs had no change in urine MCR whereas those not receiving omega-3 FAs had a 64.2% increase at one year follow-up. Conclusions: Omega-3 FAs attenuated worsening of urine MCR in diabetics with CAD compared to diabetics not receiving omega-3 FAs over a one year period. Our results suggest that a combination of omega-3 FAs and ACEI or ARB is better in attenuating the progression of microalbuminuria than ACEI or ARB alone in diabetics with CAD. This suggests that omega-3 FAs may provide additional benefit when added to ACEI/ARB in diabetics with CAD.