Red Blood Cell Eicosapentaenoic Acid Inversely Relates to MRI-Assessed Carotid Plaque Lipid Core Burden in Elders at High Cardiovascular Risk.

Núria Bargalló,Aleix Sala-Vila,Montserrat Fitó,Jordi Salas-Salvadó,Emilio Ros,Philip Calder,Montserrat Cofán,Ramon Estruch,Rosa Gilabert,Dolores Corella,Edwin-Saúl Romero-Mamani,Miguel Ruiz-Canela

doi:10.3390/nu9091036

Abstract

Supplemental marine omega-3 eicosapentaenoic acid (EPA) has an anti-atherosclerotic effect. Clinical research on EPA supplied by the regular diet and atherosclerosis is scarce. In the framework of the PREvención con DIeta MEDiterránea (PREDIMED) trial, we conducted a cross-sectional study in 161 older individuals at high vascular risk grouped into different stages of carotid atherosclerosis severity, including those without ultrasound-detected atheroma plaque (n = 38), with plaques <2.0 mm thick (n = 65), and with plaques ≥2.0 mm (n = 79). The latter were asked to undergo contrast-enhanced 3T magnetic resonance imaging (MRI) and were subsequently grouped into absence (n = 31) or presence (n = 27) of MRI-detectable plaque lipid, a main feature of unstable atheroma plaques. We determined the red blood cell (RBC) proportion of EPA (a valid marker of long-term EPA intake) at enrolment by gas chromatography. In multivariate models, EPA related inversely to MRI-assessed plaque lipid volume, but not to maximum intima-media thickness of internal carotid artery, plaque burden, or MRI-assessed normalized wall index. The inverse association between EPA and plaque lipid content in patients with advanced atherosclerosis supports the notion that this fatty acid might improve cardiovascular health through stabilization of advanced atheroma plaques.

Highlights

Atherosclerosis is the harbinger of coronary heart disease (CHD), the leading cause of mortality worldwide [1]
The novelty of the results is that this association is found in the context of the participants0 customary diet, without supplementation with either pure eicosapentaenoic acid (EPA) or fish oil
There is increasing interest in understanding how dietary habits contribute to the primary prevention of CHD, in subjects at high vascular risk

Summary

Introduction

Atherosclerosis is the harbinger of coronary heart disease (CHD), the leading cause of mortality worldwide [1]. Because of the systemic nature of atherosclerosis, the presence of atheroma plaques anywhere in the arterial tree is indicative of advanced disease in the coronary vascular beds. This evidence prompted the use of noninvasive imaging techniques to assess the atherosclerotic burden in accessible carotid arteries. The anti-atherosclerotic properties of the latter (recently reviewed in [5]) contributes to its cardioprotective effect. This notion relies mostly on the results of trials of supplementation with either pure EPA or fish oils, while studies on EPA supplied by the usual diet are scarce. Given the difficulties of accurately measuring long-term fat intake from diet records, the optimal approach to obtain reliable data is by determining the fatty acid composition of adipose tissue, circulating fatty acids are a convenient and accepted alternative [6]

Methods

Results

Conclusion