The prognostic utility of dihomo-gamma-linolenic acid (DGLA) in patients with acute coronary heart disease. (15th December 2017)

• Record Type: Journal Article
• Authors: Nilsen, Dennis W.T.; Aarsetoey, Hildegunn; Pönitz, Volker; Brugger-Andersen, Trygve; Staines, Harry; Harris, William S.; Grundt, Heidi
• Is Part Of: International journal of cardiology. Volume 249(2017)
• Page Start: 12
• Page End: 17
• Publication Date: 2017-12-15
• Subjects: Dihomo-gamma-linolenic acid (DGLA) -- Acute coronary syndrome (ACS) -- Prognosis -- Total mortality -- Myocardial infarction (MI) -- Stroke; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.09.202
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: We previously investigated the prognostic utility of red blood cell (RBC) n-3 fatty acids (FAs) in survivors of an acute myocardial syndrome (ACS) but found no relationship with all-cause mortality and cardiac death or MI after two years. Here we extend our follow-up to 7 years, focusing on the potential predictive power of RBC n-6 FAs. Methods: We included 398 ACS patients presenting with increased troponin-T (TnT) levels for whom baseline RBC FA data were available. Cox regression analysis was used to relate the risk of future events to RBC n-6 FA levels, both continuously and by quartile. Results: At 7-year follow-up, 183 (46.0%) had died, 128 (32.2%) had experienced another MI and 24 (6.0%) had had a stroke. Death or MI occurred in 227 patients (57.0%); and death, MI or stroke in 235 patients (59.0%). In a multivariable Cox regression model for total death, the hazard ratio (HR) in the highest as compared to the lowest quartile of dihomo-γ-linolenic acid (DGLA) was 0.55 [95% confidence interval (CI), 0.35–0.88, p = 0.012, for death or MI [HR 0.62 (95% CI, 0.41–0.94), p = 0.025], and for the fully combined endpoint [HR 0.57 (95% CI, 0.38–0.86), p = 0.006]. Similar results were found in the per 1-SD analysis. No other RBC n-6 FAs significantly predicted these outcomes in multivariable models. Conclusion: RBC DGLA levels had significant independent prognostic value in post-ACS patients. These findings need confirmation, and the possible biochemical pathways by which higher DGLA membrane levels may be cardioprotective should be explored.