Abstract
Fish intake, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and in some cases alpha-linolenic acid (ALA) have been associated with reduced risk of cardiovascular events and death. The association between n-3 fatty acids in plasma lipids and the progression of coronary artery atherosclerosis was assessed among women with established coronary artery disease (CAD). A prospective cohort study involved postmenopausal women (n = 228) participating in the Estrogen Replacement and Atherosclerosis Trial. Quantitative coronary angiography was performed at baseline and after 3.2 +/- 0.6 (mean +/- SD) years. Women with plasma phospholipid (PL) DHA levels above the median, compared with below, exhibited less atherosclerosis progression, as expressed by decline in minimum coronary artery diameter (-0.04 +/- 0.02 and -0.10 +/- 0.02 mm, respectively; P = 0.007) or increase in percentage stenosis (1.34 +/- 0.76% and 3.75 +/- 0.74%, respectively; P = 0.006), and had fewer new lesions [2.0% (0.5-3.5%) of measured segments (95% confidence interval) and 4.2% (2.8-5.6%), respectively; P = 0.009] after adjustments for cardiovascular risk factors. Similar results were observed for DHA in the triglycerides (TGs). EPA and ALA in plasma lipids were not significantly associated with atherosclerosis progression. Consistent with higher reported fish intake, higher levels of plasma TG and PL DHA are associated with less progression of coronary atherosclerosis in postmenopausal women with CAD.
Highlights
Fish intake, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and in some cases a-linolenic acid (ALA) have been associated with reduced risk of cardiovascular events and death
Circulating levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are good independent biomarkers of fish intake because their occurrence in the diet is limited to marine products and the rate of elongation and desaturation of a-linolenic acid (ALA) to form EPA and DHA is very low, even when ALA is present at relatively high levels [5]
We have previously demonstrated in women participating in the Estrogen Replacement and Atherosclerosis (ERA) Trial that self-reported fish intake, especially darkfleshed and tuna fish, was inversely associated with the progression of coronary atherosclerosis [22]
Summary
Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and in some cases a-linolenic acid (ALA) have been associated with reduced risk of cardiovascular events and death. Consistent with higher reported fish intake, higher levels of plasma TG and PL DHA are associated with less progression of coronary atherosclerosis in postmenopausal women with CAD.— Erkkila, A. This report is an assessment of circulating levels of plasma n-3 fatty acids, ALA, EPA, and DHA, in women with habitual fish intake and no interventional supplementation. The relationship of these biomarkers to change in mean minimum coro-. The aim of this study was to examine the association between plasma n-3 fatty acids and the progression of angiographically defined coronary atherosclerosis in a group of postmenopausal women with preexisting coronary artery disease (CAD) who underwent coronary angiography twice, 3.2 years apart [23]
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