Abstract WP242: Acute Ischemic Stroke With Atrial Fibrillation: Relation Between ω3/ω6 Poly Unsaturated Fatty Acids

Abstract

Background & Aims: Some poly unsaturated fatty acids (PUFA) are said to be associated with the development of atrial fibrillation (AF). Our aim is to elucidate the relation between PUFA and AF in acute ischemic stroke. Methods: Consecutive patients with ischemic stroke admitted between October 2012 and February 2022 were retrospectively screened. The inclusion criteria were as follows: 1) onset to door time within 7 days; and 2) availability of PUFA measurements from the day of the hospital visit or the next day. Plasma levels of PUFA, including eicosapentaenoic acid (ω3: EPA) docosahexaenoic acid (ω3: DHA), dihomo-γ-linolenic acid (ω6: DGLA), and arachidonic acids (ω6: AA), were assayed by gas chromatography. We investigated the association between each of PUFA levels and AF among the acute ischemic stroke patients. Results: We screened 2,122 consecutive ischemic stroke patients. Of them, 1,574 were identified (1,119 [71%] males, median age 69 years). In Poisson regression analysis with a robust variance estimator, factors associated with AF were lower DGLA level (prevalence ration (PR) 0.885, 95% CI 0.811 to 0.966, p = 0.006), lower AA level (PR 0.797, 95% CI 0.649 to 0.978, p = 0.029), and higher EPA/AA ratio (PR 1.353, 95% CI 1.036 to 1.766, p = 0.026). In Poisson regression analysis with a robust variance estimator for AF using PUFA quartile as indicator variables, negative linear trends were observed between the quartile of DGLA (Quartile 1: PR 1.884, Quartile 2: PR 1.530, Quartile 3: PR 1.429, Quartile 4: reference) and AA (Quartile 1: PR 1.499, Quartile 2: PR 1.199, Quartile 3: PR 1.137, Quartile 4: reference), and a positive linear trend between the quartile of EPA/AA ratio (Quartile 1: reference, Quartile 2: PR 1.544, Quartile 3: PR 1.629, Quartile 4: PR 1.781, Figure). Conclusions: In acute ischemic stroke, lower ω6 level and higher ω3/ω6 ratio were associated with the presence of AF. ω3/ω6 PUFA may have contrasting effects on the incidence of AF in acute ischemic stroke.