Abstract P119: Erythrocyte n-3 and n-6 Polyunsaturated and Trans Fatty Acids and Survival of Sudden Cardiac Arrest

Abstract

Lower levels of erythrocyte n-3 polyunsaturated fatty acid (PUFA) and higher levels of trans-fatty acid are associated with incident cardiac arrest (SCA) risk. However, it is not known whether these fatty acids also influence post-arrest survival. In addition, n-3 and n-6 PUFA play key roles in brain function and may be involved in brain resuscitation. We investigated the association of n-3, n-6 and trans-fatty acid levels with resuscitation outcomes in a population-based study of SCA. Subjects (mean age 68, 82% male) were out-of-hospital SCA patients found in ventricular fibrillation and attended by paramedics in King County, Washington, with available fatty acid measurements (n=492). Using logistic regression, we examined association between fatty acid levels and surviving to hospital admission (a proxy for heart resuscitation), and also to surviving to hospital discharge (a proxy for brain resuscitation). Both analyses adjusted for age; sex; race; year of cardiac arrest; time to arrival of emergency medical services; whether the event was witnessed, occurred in public, and whether bystander CPR was administered. Levels of arachidonic acid and trans-18:2 fatty acids were associated with SCA survival ( Table ). An increase of one SD in levels of arachidonic acid was associated with decreased likelihood of survival to both hospital admission and hospital discharge (OR (95% CI), uncorrected p-value: 0.75 (0.62-0.92), p =0.006 and 0.69 (0.55, 0.87), p =0.002, respectively). A one SD difference in trans-18:2 fatty acid levels was associated with decreased likelihood of survival to hospital discharge (0.74 (0.57-0.96), p =0.02)). Levels of n-3 PUFAs and trans-18:1 fatty acids were not associated with SCA survival. Our findings suggest arachidonic acid and trans-18:2 may influence SCA survival. Further work is needed to explore the role of fatty acid metabolism in heart and brain resuscitation. Association of Erythrocyte Fatty Acids with Resuscitation Outcomes Survival to hospital admission Survival to hospital discharge OR * (95% CI) p-value OR * (95% CI) p-value n-3 fatty acids α-Linolenic acid 1.01 (0.83-1.22) 0.95 0.85 (0.67-1.07) 0.60 EPA+DHA 1.05 (0.87-1.28) 0.60 1.10 (0.87-1.38) 0.44 n-6 fatty acids Linoleic acid 0.97 (0.80-1.18) 0.77 1.05 (0.83-1.33) 0.66 Arachidonic acid 0.75 (0.62-0.92) 0.006 0.69 (0.55-0.87) 0.002 Trans-fatty acids Trans-18:1 1.06 (0.87-1.29) 0.56 1.06 (0.84-1.34) 0.47 Trans-18:2 0.99 (0.80-1.22) 0.93 0.74 (0.57-0.96) 0.02 * OR corresponding to one SD higher levels