Am Heart J. 2013 Feb;165(2):208-15.
Plasma n-3 polyunsaturated fatty acids in chronic heart failure in the GISSI-Heart Failure Trial: relation with fish intake, circulating biomarkers, and mortality.
Masson S, Marchioli R, Mozaffarian D, Bernasconi R, Milani V, Dragani L, Tacconi M, Marfisi RM, Borgese L, Cirrincione V, Febo O, Nicolis E, Maggioni AP, Tognoni G, Tavazzi L, Latini R.
Source
Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche
"Mario Negri," Milan, Italy.
Abstract
Treatment with long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) can
improve clinical outcomes in patients with heart failure (HF). Circulating
levels of n-3 PUFA, an objective estimation of exposure, have never been
measured in a large cohort of patients with HF.
METHODS:
We measured n-3 PUFA in plasma phospholipids at baseline and after 3 months in
1,203 patients with chronic HF enrolled in the GISSI-Heart Failure trial and
randomized to n-3 PUFA 1 g/daily or placebo. N-3 PUFA levels were related to
clinical characteristics, pharmacologic treatments, dietary habits, circulating
biomarkers, and mortality.
RESULTS:
Baseline n-3 PUFA (5.1 ± 1.8 mol%) was associated with dietary fish intake, with
an average difference of 43% between patients with the lowest and highest
consumptions (P < .0001). Baseline eicosapentaenoic acid (EPA) but not
docosahexaenoic acid (DHA) was inversely related to C-reactive protein,
pentraxin-3, adiponectin, natriuretic peptide, and troponin levels. Three-month
treatment with n-3 PUFA raised their levels by 43%, independently of dietary
fish consumption; increases in EPA levels were associated with decreased
pentraxin-3. Low baseline levels of EPA but not DHA were no longer related to
higher mortality after the addition of circulating biomarkers to multivariable
models.
CONCLUSION:
Before supplementation, circulating n-3 PUFA levels in patients with chronic HF
mainly depend on dietary fish consumption and are inversely related to
inflammatory markers and disease severity. Three-month treatment with n-3 PUFA
markedly enriched circulating EPA and DHA, independently of fish intake, and
lowered pentraxin-3. Low EPA levels are inversely related to total mortality in
patients with chronic HF.
Copyright © 2013 Mosby, Inc. All rights reserved.
PMID: 23351824 [PubMed - indexed for MEDLINE]