Abstract 16679: Plasma Omega-6 Fatty Acids and the Risk of Cardiovascular Events in Patients After an Acute Coronary Syndrome

Abstract

Introduction: Prior studies have shown an inverse correlation between plasma omega-6 fatty acids (Ω6-PUFA) content and the risk of CV events in primary prevention populations. The prognostic value of Ω6-PUFA in patients after an acute coronary syndrome (ACS) is less clear. Methods: Baseline plasma Ω6-PUFA (7 species) was assessed through thin liquid chromatography in a case-control population (203 CV deaths, 271 VT, 325 MI, 161 AF and 1,612 controls) from MERLIN-TIMI 36, a randomized trial of ranolazine versus placebo in patients hospitalized with ACS. Logistic regression models were adjusted for age and sex, and then BMI, hypertension, prior MI, prior HF, diabetes mellitus, smoking, eGFR, LDL, HDL, TG, statin use, index diagnosis and treatment arm. Results: After age and sex adjustment, higher plasma gamma-linoleic acid (GLA) content was associated with a 22% lower odds of CV death (OR adj 0.78 per 1-SD, 95% CI 0.67-0.91). After further multivariable adjustment, higher plasma GLA remained significantly associated with lower odds of CV death (OR adj 0.84 per 1-SD, 0.71-0.99) [Figure] . Patients with higher plasma GLA content had significantly lower odds of AF (OR adj per 1-SD 0.79, 0.66 -0.94) and tended to have lower risk of VT (OR adj per 1-SD 0.90, 0.78-1.03; OR adj top quartile versus lowest quartile: 0.67, 0.45-1.00). GLA was not significantly associated with the risk of MI (OR adj 0.95, 0.83-1.08). Other Ω6-PUFA, including linoleic acid, were not consistently associated with CV events. Conclusions: Plasma gamma-linoleic acid content is significantly associated with the odds of CV death after ACS. Future research should examine whether dietary intake of GLA after ACS may help to attenuate CV risk.