Abstract
Data on the effects omega-3 fatty acids on coronary artery disease (CAD) are contradictory. While a recent metanalysis could not show improved cardiovascular outcomes, anti-atherogenic mechanisms are well known. Aim was to assess the influence of Omega-3 polyunsaturated long-chain fatty acids (PUFA) supplementation on coronary atherosclerosis quantified by coronary computed tomography angiography (CTA). 106 patients (59.4y±10.7; 50% females) with low-to-intermediate risk referred to CTA were included. 53 patients under omega 3-PUFA (docosahexaenoic acid, DHA and eicosapentaenoic acid, EPA) supplementation were retrospectively matched with 53 controls (CR) for age, gender and coronary risk profile (smoking, arterial hypertension, family history, dyslipidemia, c-LDL, Cholesterol, TG, diabetes) (1:1, propensity score) and lifestyle habits (exercise, alcohol consumption and nutrition). CTA analysis included 1) stenosis severity score >70%severe, 50-70% moderate, 25-50%mild, <25% minimal), 2) total plaque burden (segment involvement score (SIS) and mixed non-calcified plaque burden (G-score) and 3) high-risk-plaque features (Napkin-Ring-Sign, low attenuation plaque (LAP), spotty calcification<3mm, RI>1.1). CT-Density (Hounsfield Units, HU) of plaque was quantified by CTA. Prevalence of coronary atherosclerosis (any plaque: 83% vs. 90.6%, p=0.252), >50% stenosis and stenosis severity score (p=0.134) were not different between groups. Total and non-calcified plaque burden scores were lower in the omega-3 group (2.7 vs. 3.5, p=0.08 and 4.5 vs. 7.4, p=0.027 for SIS and G-score, resp.). Coronary artery calcium score (CACS) was similar (84.7 vs. 87.1AU). High-risk-plaque prevalence was lower in the Omega-3 group (3.8% vs. 32%, p<0.001); the number of high-risk-plaques (p<0.001) and Napkin-Ring-Sign prevalence was lower (3.8% vs. 20.9%) (p<0.001), resp. CT-density (HU) of plaque was higher in the Omega-3 group (131.6±2 vs. 62.1±27, p=0.02) indicating more fibrous-dense plaque component rather than lipid-rich atheroma. Mean duration of Omega-3 intake was 38.6±52months (range, 2-240). Omega-3-PUFA supplementation is associated with less coronary atherosclerotic "high-risk" plaque (lipid-rich) and lower total non-calcified plaque burden independent on cardiovascular risk factors. Our study supports direct anti-atherogenic effects of Omega-3-PUFA.
Highlights
IntroductionA recent metanalysis pooling 77917 patients from 10 trials could not confirm improved cardiovascular outcomes (nonfatal CHD and major adverse cardiac events (MACE)) [2]
2345 consecutive patients referred to coronary computed tomography angiography (CTA) between 2015 and 2017 were screened, and all those who completed the “lifestyle questionnaire” and met inclusion criteria were enrolled
The final cohort consisted of 106 patients with low-tointermediate coronary artery disease (CAD) risk (Table 1)
Summary
A recent metanalysis pooling 77917 patients from 10 trials could not confirm improved cardiovascular outcomes (nonfatal CHD and MACE) [2]. A large observational trial [4] which pooled 19 studies and 45 637 patients found the concentrations of DHA and EPA from both seafood and plantderived omega-3-FA being associated with a modest lower incidence of fatal CHD. 53 patients under omega 3-PUFA (docosahexaenoic acid, DHA and eicosapentaenoic acid, EPA) supplementation were retrospectively matched with 53 controls (CR) for age, gender and coronary risk profile (smoking, arterial hypertension, family history, dyslipidemia, c-LDL, Cholesterol, TG, diabetes) (1:1, propensity score) and lifestyle habits (exercise, alcohol consumption and nutrition). Conclusions: Omega-3-PUFA supplementation is associated with less coronary atherosclerotic “highrisk” plaque (lipid-rich) and lower total non-calcified plaque burden independent on cardiovascular risk factors.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.