The risk of CHD has been linked to n-3 and trans-fatty acids. The purpose of the present study was to evaluate the hypothesis that lower n-3 fatty acids and higher trans-fatty acids in erythrocytes are associated with an increased risk of acute non-fatal myocardial infarction (MI), and that fatty acid profiles can discriminate MI cases from controls. Fifty cases with acute non-fatal MI and fifty age-and sex-matched controls without MI were recruited. The Omega-3 Index (the sum of EPA and DHA in erythrocytes) was significantly lower in cases than controls (9·57 (SEM 0·28) v. 11·81 (SEM 0·35) %; P,0·001), while total trans-fatty acids were significantly higher (1·01 (SEM 0·04) v. 0·56 (SEM 0·03) %; P,0·001). The Omega-3 Index was associated with decreased risk of MI (OR 0·08 (95 % CI 0·02, 0·38); P¼0·001), while total trans-fatty acids were associated with an increased risk of MI (OR 72·67 (95 % CI 6·68, 790·74); P,0·001). The area under the receiver operating characteristic curve of fatty acid profiles was larger than that for traditional risk factors, suggesting that fatty acid profiles make a higher contribution to the discrimination of MI cases from controls compared with modified Framingham risk factors. In conclusion, a higher Omega-3 Index and lower trans-fatty acids in erythrocytes are associated with a decreased risk of MI. Furthermore, fatty acid profiles improve discrimination of acute non-fatal MI compared with established risk factors.

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The purpose of this study was to examine the hypothesis that lower in n‐3 fatty acids and higher in trans fatty acids in red blood cell (RBC) were associated with the increased risk of MI, and fatty acid profiles could discriminate MI cases from controls as compared with established risk factors. Fifty cases with a first nonfatal MI and fifty age‐ and sex matched controls without MI were recruited. The Omega‐3 Index (the sum of EPA and DHA in RBC) was significantly lower in cases than controls (9.57 ± 0.28% vs. 11.81 ± 0.35%, P < 0.001), while total trans fatty acids were significantly higher (1.01 ± 0.04% vs. 0.56 ± 0.03%, P < 0.001). Omega‐3 Index was associated with decreased risk (OR 59.0; 95% CI: 0.03, 0.09; P = 0.001), while total trans fatty acids were associated with increased risk (OR 59.0; 95% CI: 11.32, 307.51; P < 0.001). The area under the receiver operating characteristic curve of fatty acid profiles was larger than traditional factors, suggesting that fatty acid profiles contributed significantly to the discrimination of MI case from controls as compared with the modified Framingham risk factors. In conclusion, higher Omega‐3 Index and lower trans fatty acids of RBC were associated with decreased risk of nonfatal MI, and fatty acid profiles improved discrimination of nonfatal MI as compared with established risk factors.