Increase in EPA/AA Ratio Predicts Improvement in Endothelial Function in Purified Eicosapentaenoic Acid-Treated Patients
Presentation tomorrow
SESSION Poster Session 7
SPEAKER Kazuo Fukumoto
Congress : ESC Congress 2019
Topic : Preventive Cardiology
Sub-topic : Lipids: Drug therapy
Session type : Poster Session
FP Number : P6205
Authors : K Fukumoto (Osaka,JP), Y Takemoto (Osaka,JP), J Yoshikawa (Osaka,JP), N Norioka (Osaka,JP), T Iguchi (Osaka,JP), M Yoshiyama (Osaka,JP), T Shuto (Osaka,JP)
K Fukumoto1 , Y Takemoto1 , J Yoshikawa1 , N Norioka2 , T Iguchi3 , M Yoshiyama2 , T Shuto1 , 1Osaka City University Graduate School of Medicine, Department of Medical Education and General Practice - Osaka - Japan , 2Osaka City University Graduate School of Medicine, Department of Cardiovascular Medicine - Osaka - Japan , 3Bell land General Hospital, Department of Cardiovascular Medicine - Osaka - Japan ,
Citation:
Background: Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are well-known for preventing cardiovascular disease. Among n-3 PUFAs, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play key roles in preventing cardiovascular diseases. However, the effects of n-3 PUFAs have been examined under conditions of simultaneous administration of EPA and DHA in the majority of clinical investigations and the effect of purified EPA is still controversial. EPA has been reported to improve endothelial dysfunction. Although several mechanisms underlying the effects of EPA on endothelial function have been demonstrated such as the modulation of lipid metabolism including increases in high-density lipoprotein (HDL) and/or decreases in triglyceride (TG) levels, decreases in cytokine production, and inhibition of inflammatory processes, the main mechanisms ameliorating endothelial function have not been fully determined.
Purpose: We sought to clarify the main factors associated with EPA administration that led to improved endothelial function.
Methods: Fifty-one consecutive patients with hypertriglyceridemia (mean ± SD age, 60 ± 13 years) with no evidence of coronary artery disease (CAD) were prospectively enrolled and administered purified EPA (1800 mg/day). Forty-eight patients who were not administered EPA were enrolled as age- and sex-matched controls. Clinical variables such as body mass index, HbA1c, fasting glucose level, HDL, low-density lipoprotein, TG, systolic blood pressure, diastolic blood pressure, heart rate, interleukin-6, baseline diameter of the brachial artery, intima-media thickness of the brachial artery, and flow-mediated dilation (FMD) were examined before and after 6 months of treatment. Univariate and multivariate regression analyses were performed to examine the associations between FMD changes and clinical variables.
Results: FMD was significantly improved from 4.16% ± 1.88% to 6.30% ± 2.24% (p < 0.0001) in the EPA group. The change in FMD was positively correlated with the change in EPA/arachidonic acid (AA) ratio (r = 0.34, p = 0.014). The multivariate regression analysis showed that the change in EPA/AA ratio alone was significantly associated with the change in FMD (p = 0.010).
Conclusions: EPA treatment improves endothelial dysfunction in patients with hypertriglyceridemia without evidence of CAD. The change in FMD was associated with the change in EPA/AA ratio alone. These finding suggest that a direct effect of EPA on the endothelium may be the predominant factor ameliorating endothelial function.
