Abstract
Backgroundn-3 fatty acids and lifestyle also are closely related to risk of CVD. Most Koreans have higher fish consumption than people of Western populations. However, little is known about the recommended value of omega-3 index in Korean patients with acute ST-elevation myocardial infarction (STEMI) taking statins. Here, we tested the hypothesis that lower omega-3 fatty acids and/or smoking are associated with acute STEMI, even though patients with dyslipidemia who were taking statins and who attained their LDL-C goals.MethodsWe conducted a case-control study in which omega-3 fatty acids and lifestyle factors were determined in 24 consecutive Korean patients taking statins with angiographically confirmed acute STEMI and 68 healthy controls without acute STEMI. The omega-3 index was calculated by the sum of eicosapentaenoic acid and docosahexaenoic acid in erythrocyte membranes. Multivariable adjusted regression analysis was used to assess independent associations between acute STEMI, omega-3 index, and lifestyle factors after adjusting for age, sex, and body mass index (BMI).ResultsThe mean age of total subjects was 59.9 years, and 57.6% of the subjects were male. The omega-3 index was significantly lower in cases (8.83%) than controls (11.13%; P < 0.001); however, total trans-fatty acids were not different between the two groups. The omega-3 index was inversely associated with odds for being a case (OR 0.16 (95% CI 0.03-1.14); P = 0.047), while smoking was positively associated with odds for being a case (OR 6.67 (95% CI 1.77-25.23); P = 0.005) after adjusting for all confounding variables.ConclusionThis study shows that relative to controls, acute STEMI cases are more likely to be smokers and to have a lower omega-3 index, even though the cases were taking statins. An omega-3 index of at least 11% and abstinence from smoking are associated with cardioprotection for Koreans.
Highlights
Cardiovascular disease (CVD) is one of the most common causes of mortality and morbidity across the globe [1]
The sum of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) in erythrocyte (RBC) membrane fatty acids is a good reflection of systemic n-3 polyunsaturated fatty acids (PUFA) status and is called the omega-3 index, which is expressed as a percent of total identified fatty acids [13]
Multivariable adjusted regression analysis showed that the omega-3 index, age; the omega-3 index was inversely associated with odds for being a case (OR 0.16; P = 0.047), while smoking was positively associated with odds for being a case (OR 6.67; P = 0.005) after adjusting for age, gender, body mass index (BMI), alcohol drinking (Table 4)
Summary
Cardiovascular disease (CVD) is one of the most common causes of mortality and morbidity across the globe [1]. Previous studies have shown that Asians with higher fish consumption had a greater omega-3 index, and they had a higher omega-3 index than the recommended value of 8% or greater to prevent CHD for Western people. The omega-3 index in healthy Koreans and Japanese is about 11-12 and 7-11%, respectively, while it is around 4% in people from Western populations [13,14,15]. CVD is becoming more prevalent in Korea and is a leading cause of death [16], the prevalence of CVD in Korea remains lower than that in the US and other Western populations. A study of more than 40,000 middle-aged Japanese people revealed that a higher fish intake is associated with a substantially reduced risk of CHD compared to the recommended amount of fish intake in Western countries [17]
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