Red Blood Cell Eicosapentaenoic Acid Inversely Relates to MRI-Assessed Carotid Plaque Lipid Core Burden in Elders at High Cardiovascular Risk

Abstract

Supplemental marine omega-3 eicosapentaenoic acid (EPA) has an anti-atherosclerotic effect. Clinical research on EPA supplied by the regular diet and atherosclerosis is scarce. In the framework of the PREvención con DIeta MEDiterránea (PREDIMED) trial, we conducted a cross-sectional study in 161 older individuals at high vascular risk grouped into different stages of carotid atherosclerosis severity, including those without ultrasound-detected atheroma plaque (n = 38), with plaques <2.0 mm thick (n = 65), and with plaques ≥2.0 mm (n = 79). The latter were asked to undergo contrast-enhanced 3T magnetic resonance imaging (MRI) and were subsequently grouped into absence (n = 31) or presence (n = 27) of MRI-detectable plaque lipid, a main feature of unstable atheroma plaques. We determined the red blood cell (RBC) proportion of EPA (a valid marker of long-term EPA intake) at enrolment by gas chromatography. In multivariate models, EPA related inversely to MRI-assessed plaque lipid volume, but not to maximum intima-media thickness of internal carotid artery, plaque burden, or MRI-assessed normalized wall index. The inverse association between EPA and plaque lipid content in patients with advanced atherosclerosis supports the notion that this fatty acid might improve cardiovascular health through stabilization of advanced atheroma plaques.

Os Ácidos Graxos Poli-insaturados Ômega-6 e Ômega-3 Presentes nas Hemácias Exercem uma Influência Distinta sobre o Tamanho das Partículas de LDL e suas Alterações Estruturais

“…Em relação aos AGPIs n-3, as evidências clínicas recentes de DCV são mais consistentes. Estudos observacionais com AGPI n-3 de hemácias 18 , 36 - 40 e ensaios clínicos randomizados 41 - 43 mostraram que o AGPI n-3 reduz o risco de DCV. Nossos resultados corroboram o efeito cardioprotetor dos AGPIs n-3, mas mostram forte influência do ALA devido à baixa ingestão de EPA e DHA (Tabela Complementar 1).…”

“…Concerning n-3 PUFA, the recent clinical evidence for CVD is more consistent. Observational studies with RBC n-3 PUFA 18 , 36 - 40 and randomized clinical trials 41 - 43 showed that n-3 PUFA reduce CVD risk. Our results corroborate with the cardioprotective effect of n-3 PUFA but showed a strong influence of ALA due to the low EPA and DHA intake (Supplementary Table 1 ).…”

“…34,35 Em relação aos AGPIs n-3, as evidências clínicas recentes de DCV são mais consistentes. Estudos observacionais com AGPI n-3 de hemácias 18,[36][37][38][39][40] e ensaios clínicos randomizados [41][42][43] Artigo Original 44 Os fatores de risco cardiovasculares tradicionais não refletem toda a complexidade da doença aterosclerótica, tanto que os fatores de risco cardiovasculares emergentes ganharam destaque na literatura, 18,[45][46][47][48] e os efeitos dos AGPIs nas DCV estão além desses fatores. 18 Entre os diversos fatores de risco não tradicionais, o sdLDL-c demonstrou ser um melhor preditor de risco de DAC do que o LDL-c. 1 O presente estudo descobriu que os AGPIs n-6 das hemácias e a relação n-6/n-3 estavam positivamente associados ao tamanho médio menor das partículas de LDL e a níveis mais elevados de sdLDL-c. Associações semelhantes foram observadas com LA, GLA, DGLA e AA individualmente.…”

A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis

“…Previously, a study evaluating individuals with acute coronary syndrome found that for a 1 unit increase in the w3 index, the odds ratio for the disease decreased by 23% . Other studies have shown that an EPA concentration alone that is higher than 1% is associated with greater atherosclerotic plaque stabilization in carotids and a better lipid profile in high cardiovascular risk elderly patients, as well as a reduction in mortality independent of other risk factors . Recently, the omega‐3 index was associated with lower risks for total mortality, non‐CVD and noncancer mortality, and total CVD events in the Framingham Heart Study Offspring cohort.…”