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Journal of Lipid Research, Vol. 47, 2814-2819, December 2006
Copyright © 2006 by American Society for Biochemistry and Molecular Biology

Patient-Oriented Research

Higher plasma docosahexaenoic acid is associated with reduced progression of coronary atherosclerosis in women with CAD

Arja T. Erkkilä^1,*, Nirupa R. Matthan, David M. Herrington and Alice H. Lichtenstein

^* School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland
Cardiovascular Nutrition Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA
Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC

Published, JLR Papers in Press, September 18, 2006.

¹ To whom correspondence should be addressed. e-mail: arja.erkkila{at}uku.fi

ABSTRACT

Fish intake, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and in some cases -linolenic acid (ALA) have been associated with reduced risk of cardiovascular events and death. The association between n-3 fatty acids in plasma lipids and the progression of coronary artery atherosclerosis was assessed among women with established coronary artery disease (CAD). A prospective cohort study involved postmenopausal women (n = 228) participating in the Estrogen Replacement and Atherosclerosis Trial. Quantitative coronary angiography was performed at baseline and after 3.2 ± 0.6 (mean ± SD) years. Women with plasma phospholipid (PL) DHA levels above the median, compared with below, exhibited less atherosclerosis progression, as expressed by decline in minimum coronary artery diameter (–0.04 ± 0.02 and –0.10 ± 0.02 mm, respectively; P = 0.007) or increase in percentage stenosis (1.34 ± 0.76% and 3.75 ± 0.74%, respectively; P = 0.006), and had fewer new lesions [2.0% (0.5–3.5%) of measured segments (95% confidence interval) and 4.2% (2.8–5.6%), respectively; P = 0.009] after adjustments for cardiovascular risk factors. Similar results were observed for DHA in the triglycerides (TGs). EPA and ALA in plasma lipids were not significantly associated with atherosclerosis progression. Consistent with higher reported fish intake, higher levels of plasma TG and PL DHA are associated with less progression of coronary atherosclerosis in postmenopausal women with CAD.

Supplementary key words polyunsaturated fatty acids • eicosapentaenoic acid • angiography • coronary artery disease

Abbreviations: ALA, -linolenic acid; CAD, coronary artery disease; CE, cholesteryl ester; CVD, cardiovascular disease; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; PL, phospholipid; TG, triglyceride

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