Impact of n-3 polyunsaturated fatty acids in predicting ischemia/reperfusion injury and progression of myocardial damage after reperfusion in patients with ST-segment elevation acute myocardial infarction.

Abstract

BACKGROUND:

In animal models of acute myocardial infarction, n-3 polyunsaturated fatty acids (PUFAs) administered before coronary occlusion have been suggested to prevent induction of ventricular arrhythmia and limit infarct size. However, the relation between the serum levels of n-3 PUFAs and ischemia/reperfusion (I/R) injury remains unclear.

METHODS:

211 patients with ST-segment elevation acute myocardial infarction received emergency percutaneous coronary intervention (PCI) within 6h from the onset. The patients were divided into two groups according to the sum of serum eicosapentaenoic acid (EPA) levels and docosahexaenoic acid (DHA) levels before PCI: group L (n=106), EPA+DHA <155μg/ml and group H (n=105), EPA+DHA ≥155μg/ml. The Selvester QRS-scoring system was used to estimate the serial change in infarct size.

RESULTS:

Time to reperfusion was similar between the 2 groups. The QRS score before PCI was higher in group L than in group H (2.42±2.00 vs 1.85±2.01, p=0.015). The proportion of patients with I/R injury immediately after reperfusion, defined as reperfusion ventricular arrhythmias (25% vs 11%, p=0.006) and ST-segment re-elevation (44% vs 22%, p<0.001), was also higher in group L than in group H, followed by a greater increment in the QRS score during PCI (3.51±2.51 vs 2.54±1.91, p=0.006) and higher peak levels of creatinine phosphokinase (3552±241U/L vs 2660±242U/L, p<0.01). On multivariate analysis, serum level of EPA+DHA was an independent predictor of reperfusion injury (odds ratio 0.985, p=0.032).

CONCLUSION:

Serum level of n-3 PUFAs before PCI may be a predictor of I/R injury and the resultant extent of myocardial damage. These findings suggest a protective effect of serum n-3 PUFAs on ischemic myocardium.

• Authors: Kentaro Arakawa, Hideo Himeno, Jin Kirigaya, Fumie Otomo, Kensuke Matsushita, Hidefumi Nakahashi, Satoru Shimizu, Manabu Nitta, Hideto Yano, Mitsuaki Endo, Kazuo Kimura, Satoshi Umemura
• Journal: Journal of cardiology (J Cardiol) Vol. 66 Issue 2 Pg. 101-7 (Aug 2015) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 25847089 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers
• Docosahexaenoic Acids
• Eicosapentaenoic Acid

Topics

• Aged
• Biomarkers (blood)
• Disease Progression
• Docosahexaenoic Acids (blood)
• Eicosapentaenoic Acid (blood)
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, surgery)
• Myocardial Reperfusion Injury (diagnostic imaging, etiology)
• Odds Ratio
• Percutaneous Coronary Intervention (adverse effects)
• Predictive Value of Tests
• Radiography
• Time Factors