Low levels of EPA, DHA up risk of early-onset coronary atherosclerosis

Individuals with low levels of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are at increased risk of early-onset coronary atherosclerosis, according to a recent study.

Coronary artery calcification (CAC) in symptomatic patients was quantified based on Agatston’s method using noncontrast coronary computed tomography (CT). The authors examined the association of EPA and DHA with early-onset coronary atherosclerosis, defined as presence of CAC above the 75th Agatston-Score (AS) percentile in sex-adjusted age categories.

A standardized methodology was applied to analyse the erythrocyte fatty acid composition. The percentage of EPA and DHA, with respect to all fatty acids present in the erythrocyte membrane, was deemed the Omega-3 Index.

Seventy-one patients were included in this study, of whom 51 were below and 20 were above the 75th AS-percentile. There were no differences observed in age, gender, cardiovascular risk factors and relevant medication.

Univariable analysis revealed that patients above the 75th AS-percentile had significantly lower values for EPA (0.77 percent vs 0.93 percent; p=0.045), DHA (4.90 percent vs 5.50 percent; p=0.038) and the Omega-3 Index (5.73 percent vs 6.22 percent; p=0.034). All other fatty acids showed no significant differences.

Furthermore, multivariable analysis bared a significant inverse association between the Omega-3 Index and early onset of CAC (odds ratio, 0.533, 95 percent confidence interval, 0.303–0.938; p=0.029), independent of age, gender, statin use and creatinine level (p_all>0.05).

“This finding needs to be validated in larger cohorts and might help understand the beneficial cardiovascular effects of omega-3 fatty acids,” the researchers said.