Omega-3 Status and the Relationship between Plasma Asymmetric Dimethylarginine and Risk of Myocardial Infarction in Patients with Suspected Coronary Artery Disease.

Heidi Borgeraas,Elin Strand,Eirik Rebnord Wilberg,Dennis W T Nilsen,Ottar Nygård,Pavol Bohov,Reinhard Seifert,Per Magne Ueland,Jutta Dierkes,Rolf K Berge,Eva Ringdal Pedersen

doi:10.1155/2012/201742

Abstract

Background. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase. A previous rat study revealed an ADMA lowering effect following treatment with omega-3 polyunsaturated fatty acids (n-3 PUFAs). We sought to examine if an association between plasma ADMA and risk of acute myocardial infarction (AMI) was modified by serum n-3 PUFA status. Methods. The cohort included 1364 patients who underwent coronary angiography for suspected coronary artery disease in 2000-2001. Fatal and nonfatal AMI events were registered until December 31, 2006. Risk associations with AMI were estimated across ADMA quartiles (linear trend) and the upper decile. Results. No association between concentration of any n-3 PUFA and ADMA was observed. Only ADMA levels in upper decile were significantly associated with AMI with a multivariate adjusted hazard ratio (HR) (95% confidence interval) versus the rest of the population of 2.11 (1.34, 3.32). The association was strengthened among patients with below median levels of α-linolenic acid (ALA) (HR 3.12 (1.64, 5.93)), but was only influenced by longer chain n-3 PUFA after additional adjustments for HbA1c, estimated glomerular filtration rate, and hypercholesterolemia. Conclusions. The association of ADMA with risk of AMI is influenced by serum n-3 PUFA and particularly ALA.

Highlights

An early and critical event in the pathogenesis of cardiovascular disease (CVD) is endothelial dysfunction
food-frequency questionnaire (FFQ) data on dietary habits during last year were available from 705 patients who participated in Western Norway B Vitamin Intervention Trial (WENBIT), and the mean (SD) intake of fish was 119 (67.7) g/d and 116 (63.3) g/d for quartile 1 and 4, respectively, with no significant difference in fish intake between the Asymmetric dimethylarginine (ADMA) quartiles
The model included age, sex, acute coronary syndrome, diabetes mellitus, hypertension, current smoking, extend of coronary artery disease (0–3), left ventricular ejection fraction, hypercholesterolemia, HbA1c, and glomerular filtration rate. 4Combination of ALA, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). 5Combination of EPA, DPA, and DHA. In this prospective cohort study, we identified plasma ADMA levels in the upper decile to be moderately associated with risk of acute myocardial infarction (AMI)

Summary

Introduction

An early and critical event in the pathogenesis of cardiovascular disease (CVD) is endothelial (vasodilator) dysfunction. A high plasma level of ADMA is regarded as an independent predictor of CVD and is associated with end stage renal disease [4]. We sought to examine if an association between plasma ADMA and risk of acute myocardial infarction (AMI) was modified by serum n-3 PUFA status. Risk associations with AMI were estimated across ADMA quartiles (linear trend) and the upper decile. The association was strengthened among patients with below median levels of α-linolenic acid (ALA) (HR 3.12 (1.64, 5.93)), but was only influenced by longer chain n-3 PUFA after additional adjustments for HbA1c, estimated glomerular filtration rate, and hypercholesterolemia. The association of ADMA with risk of AMI is influenced by serum n-3 PUFA and ALA

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