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Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio as an associated factor of high risk plaque on coronary computed tomography in patients without coronary artery disease.
Atherosclerosis. 2016 07; 250:30-7.A

Abstract

BACKGROUND AND AIMS

Coronary computed tomography angiography (CCTA)-verified high risk plaque (HRP) characteristics including positive remodeling and low attenuation plaque have been associated with acute coronary syndromes. Several studies reported that the n-3 polyunsaturated fatty acids have been associated with cardiovascular events. However, the relationship between serum eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio and CCTA-verified HRP in patients without known coronary artery disease (CAD) is unclear. We aimed at investigating the relation between EPA/AA and CCTA-verified HRP in patients without known CAD.

METHODS

We included 193 patients undergoing CCTA without known CAD (65.5 ± 12.0 years, 55.0% male). No patient has been treated with EPA. The relation of coronary risk factors, lipid profile, high-sensitivity C-reactive protein, coronary artery calcification score (CACS), number of vessel disease, plaque burden, and EPA/AA with the presence of HRP was evaluated by logistic regression analysis. Incremental value of EPA/AA to predict HRP was also analyzed by C-index, NRI, and IDI. A Cox proportional hazards model was used to estimate the time to cardiovascular event.

RESULTS

HRP was observed in 37 (19%) patients. Multivariable logistic regression analysis revealed that current smoking (OR 2.58; p=0.046), number of vessel disease (OR 1.87; p=0.031), and EPA/AA ratio (OR 0.65; p=0.0006) were independent associated factors of HRP on CCTA. Although the addition of EPA/AA to the baseline model did not significantly improve C-index, both NRI (0.60, p=0.0049) and IDI (0.054, p=0.0072) were significantly improved. Patients with HRP had significantly higher rate of events compared with patients without HRP (14% vs. 3%, Logrank p=0.0004). On multivariable Cox hazard analysis, baseline EPA/AA ratio was an independent predictor (HR 0.57, p=0.047).

CONCLUSIONS

Low EPA/AA was an associated factor of HRP on CCTA in patients without CAD. In addition to conventional coronary risk factors and CACS, EPA/AA and CCTA might be useful for risk stratification of CAD.

Authors+Show Affiliations

Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: xxxyasunagaxxx@e-mail.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: sadakom@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: msarai@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: pole1207@hotmail.co.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: hidekikawai@xc4.so-net.ne.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: youkot@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: mmiyagi@fujita-hu.ac.jp.Department of Radiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: dshibata@fujita-hu.ac.jp.Division of Medical Statistics, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: hirotaka@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: hnaruse@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: jishii@fujita-hu.ac.jp.Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. Electronic address: ozakiyuk@fujita-hu.ac.jp.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27175609

Citation

Nagahara, Yasuomi, et al. "Eicosapentaenoic Acid to Arachidonic Acid (EPA/AA) Ratio as an Associated Factor of High Risk Plaque On Coronary Computed Tomography in Patients Without Coronary Artery Disease." Atherosclerosis, vol. 250, 2016, pp. 30-7.
Nagahara Y, Motoyama S, Sarai M, et al. Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio as an associated factor of high risk plaque on coronary computed tomography in patients without coronary artery disease. Atherosclerosis. 2016;250:30-7.
Nagahara, Y., Motoyama, S., Sarai, M., Ito, H., Kawai, H., Takakuwa, Y., Miyagi, M., Shibata, D., Takahashi, H., Naruse, H., Ishii, J., & Ozaki, Y. (2016). Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio as an associated factor of high risk plaque on coronary computed tomography in patients without coronary artery disease. Atherosclerosis, 250, 30-7. https://doi.org/10.1016/j.atherosclerosis.2016.04.026
Nagahara Y, et al. Eicosapentaenoic Acid to Arachidonic Acid (EPA/AA) Ratio as an Associated Factor of High Risk Plaque On Coronary Computed Tomography in Patients Without Coronary Artery Disease. Atherosclerosis. 2016;250:30-7. PubMed PMID: 27175609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio as an associated factor of high risk plaque on coronary computed tomography in patients without coronary artery disease. AU - Nagahara,Yasuomi, AU - Motoyama,Sadako, AU - Sarai,Masayoshi, AU - Ito,Hajime, AU - Kawai,Hideki, AU - Takakuwa,Yoko, AU - Miyagi,Meiko, AU - Shibata,Daisuke, AU - Takahashi,Hiroshi, AU - Naruse,Hiroyuki, AU - Ishii,Junichi, AU - Ozaki,Yukio, Y1 - 2016/04/27/ PY - 2015/11/14/received PY - 2016/04/18/revised PY - 2016/04/26/accepted PY - 2016/5/14/entrez PY - 2016/5/14/pubmed PY - 2017/12/21/medline KW - Coronary CT KW - Coronary artery disease KW - EPA/AA KW - High risk plaque SP - 30 EP - 7 JF - Atherosclerosis JO - Atherosclerosis VL - 250 N2 - BACKGROUND AND AIMS: Coronary computed tomography angiography (CCTA)-verified high risk plaque (HRP) characteristics including positive remodeling and low attenuation plaque have been associated with acute coronary syndromes. Several studies reported that the n-3 polyunsaturated fatty acids have been associated with cardiovascular events. However, the relationship between serum eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio and CCTA-verified HRP in patients without known coronary artery disease (CAD) is unclear. We aimed at investigating the relation between EPA/AA and CCTA-verified HRP in patients without known CAD. METHODS: We included 193 patients undergoing CCTA without known CAD (65.5 ± 12.0 years, 55.0% male). No patient has been treated with EPA. The relation of coronary risk factors, lipid profile, high-sensitivity C-reactive protein, coronary artery calcification score (CACS), number of vessel disease, plaque burden, and EPA/AA with the presence of HRP was evaluated by logistic regression analysis. Incremental value of EPA/AA to predict HRP was also analyzed by C-index, NRI, and IDI. A Cox proportional hazards model was used to estimate the time to cardiovascular event. RESULTS: HRP was observed in 37 (19%) patients. Multivariable logistic regression analysis revealed that current smoking (OR 2.58; p=0.046), number of vessel disease (OR 1.87; p=0.031), and EPA/AA ratio (OR 0.65; p=0.0006) were independent associated factors of HRP on CCTA. Although the addition of EPA/AA to the baseline model did not significantly improve C-index, both NRI (0.60, p=0.0049) and IDI (0.054, p=0.0072) were significantly improved. Patients with HRP had significantly higher rate of events compared with patients without HRP (14% vs. 3%, Logrank p=0.0004). On multivariable Cox hazard analysis, baseline EPA/AA ratio was an independent predictor (HR 0.57, p=0.047). CONCLUSIONS: Low EPA/AA was an associated factor of HRP on CCTA in patients without CAD. In addition to conventional coronary risk factors and CACS, EPA/AA and CCTA might be useful for risk stratification of CAD. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/27175609/Eicosapentaenoic_acid_to_arachidonic_acid__EPA/AA__ratio_as_an_associated_factor_of_high_risk_plaque_on_coronary_computed_tomography_in_patients_without_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(16)30157-5 DB - PRIME DP - Unbound Medicine ER -