Plasma cis-vaccenic acid and risk of heart failure with antecedent coronary heart disease in male physicians

Abstract

Although an inverse association of red blood cell cis-vaccenic acid and risk of myocardial infarction has been reported, it is unclear whether cis-vaccenic acid might lower the risk of heart failure (HF) with antecedent coronary heart disease (CHD). We sought to examine the relation of plasma cis-vaccenic acid with HF with antecedent CHD. This nested case-control study was based on 788 incident HF cases (of whom 258 cases had antecedent CHD) and 788 controls. Each control was selected using a risk set sampling technique at the time of the occurrence of the index case and matched on year of birth, age at blood collection, and race. Fatty acids were measured using gas chromatography and incident HF was self-reported on annual questionnaires and validation in a subsample using medical records. In a multivariable conditional logistic regression, the odds ratio (95% confidence interval) for HF with prior CHD were 1.0 (ref), 0.72 (0.33-1.57), 0.28 (0.12-0.67), and 0.23 (0.09-0.58) across consecutive quartiles of cis-vaccenic acid (p_trend 0.0004). Each standard deviation of cis-vaccenic acid was associated with a 41% lower risk of HF with antecedent CHD (95% CI: 17%-59%) in a multivariable adjusted model. Our data suggest that higher plasma levels of plasma cis-vaccenic acid may be associated with a lower risk of HF with antecedent CHD. Confirmation of these results in the general population including women and other ethnic groups is warranted.