Nutritional preconditioning by marine omega-3 fatty acids in patients with ST-segment elevation myocardial infarction: A METOCARD-CNIC trial substudy

Aleix Sala-Vila, Rodrigo Fernández-Jiménez, Gonzalo Pizarro, Carlos Calvo, Jose M. García-Ruiz, Leticia Fernández-Friera, Maite D. Rodriguez, Noemí Escalera, Jorge Palazuelos, Angel Macías, Braulio Pérez-Asenjo, Antonio Fernández-Ortiz, Emilio Ros, Valentín Fuster, Borja Ibáñez

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background Marine omega-3 eicosapentaenoic acid (EPA) is readily incorporated into cardiomyocyte membranes, partially displacing the omega-6 arachidonic acid (AA). Whereas AA is a substrate for pro-inflammatory eicosanoids, the release of EPA from cell membranes generates anti-inflammatory lipid mediators, contributing to the infarct-limiting effect observed experimental models. Clinical data are lacking. Methods In this observational study conducted in 100 patients with a reperfused anterior ST-elevation myocardial infarction (STEMI), at hospital admission we quantified by gas-chromatography the red blood cell proportions of AA, EPA, and the AA:EPA ratio, a valid surrogate for cardiomyocyte membrane content. Patients underwent cardiac magnetic resonance imaging in the acute phase (one week post-STEMI), and at long-term (6 months) follow-up. Infarct size (delayed gadolinium enhancement) and cardiac function (left ventricular ejection fraction [LVEF]) were correlated with exposures of interest by multivariate regression analysis. Results AA:EPA ratio directly related to acute infarct size (coefficient [95% CI]: 6.19 [1.68 to 10.69], P = 0.008) and inversely to long-term LVEF (coefficient [95% CI]: − 4.02 [− 7.15 to − 0.89], P = 0.012). EPA inversely related to acute infarct size (coefficient [95% CI]: − 6.58; [− 11.46 to − 1.70]; P = 0.009), while a direct association with LVEF at follow-up (coefficient [95% CI]: 3.67 [0.25 to 7.08]; P = 0.036) was observed. Conclusions A low AA:EPA ratio in red blood cells at the time of STEMI is associated with smaller acute infarct size and preserved long-term ventricular function. Our results are consistent with prior work in experimental models and add to the notion of omega-3 fatty acids as a healthy fat. Trial registration http://www.clinicaltrials.gov/NCT01311700

Original languageEnglish
Pages (from-to)828-833
Number of pages6
JournalInternational Journal of Cardiology
Volume228
DOIs
StatePublished - 1 Feb 2017

Keywords

  • Fatty acids
  • Myocardial infarction
  • Nutrition

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