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Nutrition and Disease

(n-3) Fatty Acid Content of Red Blood Cells Does Not Predict Risk of Future Cardiovascular Events following an Acute Coronary Syndrome^1,2

³ Department of Medicine ⁴ Division of Cardiology, Stavanger University Hospital, 4068 Stavanger, Norway ⁵ Institute of Medicine, University of Bergen, 5020 Bergen, Norway ⁶ Sigma Statistical Services, KY16 ODH Balmullo, Scotland, UK ⁷ Sanford Research/University of South Dakota and Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57069

A reduced risk of fatal coronary artery disease has been associated with a high intake of (n-3) fatty acids (FA) and a direct cardioprotective effect by their incorporation into myocardial cells has been suggested. Based on these observations, the omega-3 index (eicosapentaenoic acid + docosahexaenoic acid in cell membranes of RBC expressed as percent of total FA) has been suggested as a new risk marker for cardiac death. In this study, our aim was to evaluate the omega-3 index as a prognostic risk marker following hospitalization with an acute coronary syndrome (ACS). The omega-3 index was measured at admission in 460 patients with an ACS as defined by Troponin-T (TnT) 0.02 µg/L. During a 2-y follow-up, recurrent myocardial infarctions (MI) (defined as TnT >0.05 µg/L with a typical MI presentation) and cardiac and all-cause mortality were registered. Cox regression analyses were used to relate the risk of new events to the quartiles of the omega-3 index at inclusion. After correction for age, sex, previous heart disease, hypertension, diabetes, smoking, high-sensitivity C-reactive protein, brain natriuretic peptide, creatinine, total cholesterol, HDL-cholesterol, triacylglycerol, homocysteine, BMI, and medication, there was no significant reduction in risk for all-cause mortality, cardiac death, or MI with increasing values of the index. In conclusion, we could not confirm the omega-3 index as a useful prognostic risk marker following an ACS.

^* To whom correspondence should be addressed. E-mail: grundt{at}madlalia.label.

Manuscript received 24 July 2008. Initial review completed 1 October 2008. Revision accepted 29 December 2008.