Abstract 4173: Statin Use is Associated with Higher Levels of Total and Long-Chain n-3 Fatty Acids and Lower Levels of n-6 and Saturated Fatty Acids in Patients Following Acute Myocardial Infarction

Abstract

Background: Higher plasma n-3 fatty acid levels are associated with improved long-term outcomes in the primary and secondary prevention of CHD. Besides anti-arrhythmic effects, n-3 fatty acids have been shown to possess other pleiotropic effects including anti-inflammatory and antithrombotic effects in a fashion similar to statins. The effect of statin use on fatty acid synthesis and metabolism has received little attention in CHD patients. The objective of this study was to evaluate the relationship between statin use, plasma fatty acid levels and estimated desaturase activity in patients following acute myocardial infarction. Methods: Clinical and metabolic parameters including fasting plasma fatty acid levels were measured in 734 subjects, approximately eight weeks following AMI. Correlations were evaluated between statin use, fatty acid levels and desaturase activity. Results: Statin use was observed in 539 of 734 patients and was associated with higher levels of total n-3 (r=0.10, P=0.005) and long-chain n-3 fatty acids (ecosapentanoeic acid r=0.11, P=0.004; docosahexanoeic acid r=0.12, P=0.001) and lower n-6 (linoleic acid r=-0.24, P<0.001) and total saturated fatty acid levels (r=-.083, P=0.025). Multivariate models adjusted for age, sex, smoking, physical activity level and the components of the metabolic syndrome did not significantly alter the observed associations. Statin use correlated negatively with estimated Δ-9 desaturase activity (r=-0.08, P=0.025) and positively with Δ-5 activity (r=0.23, P<0.001). Conclusions: Statin use is associated with an improved plasma fatty acid profile characterized by higher levels of total and long-chain n-3 fatty acids and lower levels of saturated and certain n-6 fatty acids. We cannot exclude that dietary factors may have influenced the observed associations. Our data is consistent with basic science investigations and randomized trials in non-CHD patients demonstrating that statins do influence fatty acid synthesis and metabolism. Whether the pleiotropic effects of statins may in part be due to an improved fatty acid profile requires further study in prospective clinical trials.