Baseline Plasma Fatty Acids Profile and Incident Cardiovascular Events in the SU.FOL.OM3 Trial: The Evidence Revisited

Léopold K Fezeu,Emmanuelle Kesse-Guyot,Serge Hercberg,François Laporte,Pilar Galan,Jacques Blacher,Valentina A Andreeva,Vincenzo Lionetti

doi:10.1371/journal.pone.0092548

Abstract

ObjectiveWe aimed to investigate the association between baseline plasma fatty acids profile and the risk of future major cardiovascular events in patients with a history of ischaemic heart disease or ischemic stroke.MethodsBaseline plasma fatty acids as well as established cardiovascular risk factors were measured in 2,263 patients enrolled in the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids randomized controlled trial. Incident major cardiovascular, cardiac and cerebrovascular events were ascertained during the 4.7 years of follow up. Hazard ratios were obtained from Cox proportional hazards models after adjustment for cardiovascular risk factors.ResultsDuring the follow-up, 154, 379 and 84 patients had major cardiovascular, cardiac and cerebrovascular events respectively. Upon adjustment for gender, initial event, baseline age and BMI, the risk of developing a major cardiovascular event decreased significantly in successive quartiles of arachidonic acid (Ptrend<0.002), total omega 3 polyunsaturated fatty acids (Ptrend<0.03), docosapentaenoic acid (Ptrend<0.019), docosahexaenoic acid (Ptrend<0.004), eicosapentaenoic acid + docosahexaenoic acid (Ptrend<0.03) and eicosapentaenoic acid + docosapentaenoic acid + docosahexaenoic acid (Ptrend<0.02). This inverse association was borderline significant with increased quartiles of stearidonic acid (Ptrend<0.06). In the full model, only stearidonic acid remained inversely associated with the risk of developing a major cardiovascular event (Ptrend<0.035), a cardiac event (Ptrend<0.016) or a cerebrovascular event (Ptrend<0.014), while arachidonic acid was inversely associated with the risk a cerebrovascular event (Ptrend<0.033).ConclusionThe inverse association of long chain omega 3 polyunsaturated fatty acids with recurrence of Cardiovascular diseases was mainly driven by well-known cardiovascular risk factors.Trial RegistrationControlled-Trials.com ISRCTN41926726

Highlights

The incidence of cardiovascular diseases (CVD) is suggested to be modulated by dietary fatty acid composition, ie saturated fatty acids (SFA) increasing and polyunsaturated fatty acids (PUFA) decreasing serum cholesterol levels and risk of CVD [1]
SFA and monounsaturated fatty acids (MUFA) are the main components of triglycerides, mechanisms linking the relationships between CVD and individual fatty acids remain uncertain
In the present ancillary analysis of the SU.FOL.OM3 trial, we explored the association between baseline plasma fatty acids (PFA) and the risk of secondary cardiovascular events in this population with recent medical history of CVD

Summary

Introduction

The incidence of cardiovascular diseases (CVD) is suggested to be modulated by dietary fatty acid composition, ie saturated fatty acids (SFA) increasing and polyunsaturated fatty acids (PUFA) decreasing serum cholesterol levels and risk of CVD [1]. Some fatty acids influence the incidence of CVD through triglyceride accumulation, inflammation, vasodilation, or platelet aggregation [2]. SFA and monounsaturated fatty acids (MUFA) are the main components of triglycerides, mechanisms linking the relationships between CVD and individual fatty acids remain uncertain. N EPA + DPA supplementation, n (%) Age, years Men, n (%) BMI, kg/m2 SBP, mm Hg DBP, mm Hg MAP, mm Hg Total energy intake, kcal/day Total fibre intake, g/day Total fish intake, g/day Fat fish intake, g/day Total cholesterol, mmol/L HDL-cholesterol, mmol/L LDL-cholesterol, mmol/L Triglycerides, mmol/L Glycaemia, mmol/L Smoking status, n (%).

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