874 articles - 10.09.10
1: Lancet. 2010 Aug 14;376(9740):540-50. Epub 2010 Jul 15.
Saravanan P, Davidson NC, Schmidt EB, Calder PC.
Cardiovascular Research Group, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. drplsuk@yahoo.co.uk
Much evidence shows that the marine omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid have beneficial effects in various cardiac disorders, and their use is recommended in guidelines for management of patients after myocardial infarction. However, questions have been raised about their usefulness alongside optimum medical therapies with agents proven to reduce risk of cardiac events in high-risk patients. Additionally, there is some evidence for a possible pro-arrhythmic effect in subsets of cardiac patients. Some uncertainly exists about the optimum dose needed to obtain beneficial effects and the relative merit of dietary intake of omega-3 polyunsaturated fatty acids versus supplements. We review evidence for the effects of omega-3 polyunsaturated fatty acids on various cardiac disorders and the risk factors for cardiac disease. We also assess areas of uncertainty needing further research. Copyright 2010 Elsevier Ltd. All rights reserved.
Publication Types: Research Support, Non-U.S. Gov't Review
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PMID: 20638121 [PubMed - indexed for MEDLINE]2: Am Heart J. 2010 Jun;159(6):1020-5.
Ebbesson SO, Devereux RB, Cole S, Ebbesson LO, Fabsitz RR, Haack K, Harris WS, Howard WJ, Laston S, Lopez-Alvarenga JC, MacCluer JW, Okin PM, Tejero ME, Voruganti VS, Wenger CR, Howard BV, Comuzzie AG.
Norton Sound Health Corporation, Nome, AK, USA. soebbesson@alaska.edu
BACKGROUND: Consumption of omega-3 fatty acids (FAs) is associated with a reduction in deaths from coronary heart disease, arrhythmia, and sudden death. Although these FAs were originally thought to be antiatherosclerotic, recent evidence suggests that their benefits are related to reducing risk for ventricular arrhythmia and that this may be mediated by a slowed heart rate (HR). METHODS: The study was conducted in Alaskan Eskimos participating in the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) Study, a population experiencing a dietary shift from unsaturated to saturated fats. We compared HR with red blood cell (RBC) FA content in 316 men and 391 women ages 35 to 74 years. RESULTS: Multivariate linear regression analyses of individual FAs with HR as the dependent variable and specific FAs as covariates revealed negative associations between HR and docosahexaenoic acid (22:6n-3; P = .004) and eicosapentaenoic acid (20:5n-3; P = .009) and positive associations between HR and palmitoleic acid (16:1n-7; P = .021), eicosanoic acid (20:1n9; P = .007), and dihomo-gamma-linolenic acid (DGLA; 20:3n-6; P = .021). Factor analysis revealed that the omega-3 FAs were negatively associated with HR (P = .003), whereas a cluster of other, non-omega-3 unsaturated FAs (16:1, 20:1, and 20:3) was positively associated. CONCLUSIONS: Marine omega-3 FAs are associated with lower HR, whereas palmitoleic and DGLA, previously identified as associated with saturated FA consumption and directly related to cardiovascular mortality, are associated with higher HR. These relations may at least partially explain the relations between omega-3 FAs, ventricular arrhythmia, and sudden death. Copyright 2010 Mosby, Inc. All rights reserved.
Publication Types: Comparative Study Research Support, N.I.H., Extramural
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PMID: 20569715 [PubMed - indexed for MEDLINE]3: Am J Clin Nutr. 2010 Jul;92(1):244-51. Epub 2010 May 19.
Manger MS, Strand E, Ebbing M, Seifert R, Refsum H, Nordrehaug JE, Nilsen DW, Drevon CA, Tell GS, Bleie O, Vollset SE, Pedersen ER, Nygard O.
Institute of Medicine, University of Bergen, Bergen, Norway.
BACKGROUND: Consumption of fish and n-3 (omega-3) long-chain polyunsaturated fatty acids (LCPUFAs) has been associated with reduced risk of coronary artery disease (CAD) mortality. OBJECTIVE: The aim was to examine the relation between dietary intake of n-3 LCPUFAs or fish and risk of future coronary events or mortality in patients with well-characterized CAD. DESIGN: This was a substudy of 2412 participants in the Western Norway B Vitamin Intervention Trial with a median follow-up time of 57 mo. Patients aged >18 y diagnosed with CAD (81% men) completed a food-frequency questionnaire at baseline, from which daily intakes of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids as well as fish were estimated on the basis of diet and intakes of supplements including fish and cod liver oils. The main endpoint was a composite of coronary events, including coronary death, nonfatal acute myocardial infarction, and unstable angina pectoris. RESULTS: The mean (+/-SD) intakes of n-3 LCPUFAs in quartiles 1-4 were 0.58 +/- 0.29, 0.83 +/- 0.30, 1.36 +/- 0.44, and 2.64 +/- 1.18 g/d, respectively. We found no dose-response relation between quartiles of n-3 LCPUFAs (based on intake as percentage of total energy) or fish and coronary events or separate endpoints. A post hoc additive proportional hazards model showed a slightly increased risk of coronary events at an intake of n-3 LCPUFAs < approximately 0.30 g/d. CONCLUSION: Among Norwegian patients with CAD consuming relatively high amounts of n-3 LCPUFAs and fish, there were no significant trends toward a reduced risk of coronary events or mortality with increasing intakes. This trial was registered at clinicaltrials.gov as NCT00354081.
Publication Types: Research Support, Non-U.S. Gov't
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PMID: 20484456 [PubMed - indexed for MEDLINE]4: Future Cardiol. 2010 May;6(3):343-50.
Manerba A, Vizzardi E, Metra M, Dei Cas L.
Department of Cardiology, University of Brescia, Piazza del Mercato, Italy.
Today, there are several observational and experimental studies, especially clinical randomized trials, that have proven the beneficial effects of n-3 polyunsaturated fatty acids (PUFAs). The most compelling evidence for the cardiovascular benefits of n-3 PUFAs comes from studies of primary prevention in patients following myocardial infarction, and most recently, in patients with heart failure. In this review, we analyze the evidence from epidemiologic studies and from large randomized controlled trials showing the benefits of n-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in primary and secondary cardiovascular prevention. Further studies are needed to determine optimal dosing and the relative ratio of DHA and EPA that provide maximal cardioprotection.
Publication Types: Review
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PMID: 20462340 [PubMed - indexed for MEDLINE]5: Am J Physiol Heart Circ Physiol. 2010 Jul;299(1):H153-64. Epub 2010 Apr 30.
Keyes KT, Ye Y, Lin Y, Zhang C, Perez-Polo JR, Gjorstrup P, Birnbaum Y.
Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, TX, USA.
The purpose of the present study was to assess whether resolvin E1 (RvE1), an anti-inflammatory mediator derived from eicosapentaenoic acid, would limit myocardial infarct size in the rat. The H9c2 cell line was used to assess whether RvE1 has direct protective effects on cardiomyocytes. In in vivo experiments, Male Sprague-Dawley rats underwent 30 min of ischemia/4 h of reperfusion. Before reperfusion, rats received intravenous RvE1 (0, 0.03, 0.1, or 0.3mg/kg). In in vitro experiments, H9c2 cells were incubated with RvE1 (0, 1, 10, 100, or 1000 nM). Cells were subjected to 18 h of incubation under normoxic conditions, 16 h of hypoxia, or 16 h of hypoxia and 2 h of reoxygenation. In vivo, RvE1 dose dependently reduced infarct size (30.7 +/- 1.7% of the area at risk in the control group and 29.1 +/- 1.6%, 14.7 +/- 1.3%, and 9.0 +/- 0.6% in the 0.03, 0.1, and 0.3 mg/kg groups, respectively, P < 0.001). In vitro, RvE1 increased viability and decreased apoptosis in a dose-dependent fashion in cells exposed to hypoxia or hypoxia/reoxygenation. A maximal effect was achieved at a concentration of 100 nM. RvE1 augmented phosphoinositide 3-kinase activity, attenuated caspase-3 activity, and augmented calcium-dependent nitric oxide synthase activity in cells exposed to hypoxia or hypoxia/reoxygenation. RvE1 increased Akt, ERK1/2, and endothelial nitric oxide synthase phosphorylation and attenuated the levels of activated caspase-3 and phosphorylated p38 levels. AG-1478, an EGF receptor tyrosine kinase inhibitor, blocked the protective effect of RvE1 both in vivo and in vitro and attenuated the RvE1-induced increase in Akt and ERK1/2 phosphorylation. In conclusion, RvE1, an anti-inflammatory mediator derived from eicosapentaenoic acid, has a direct protective effect on cardiomyocytes against ischemia-reperfusion injury and limits infarct size when administered intravenously before reperfusion.
Publication Types: Research Support, Non-U.S. Gov't
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PMID: 20435846 [PubMed - indexed for MEDLINE]6: J Am Coll Cardiol. 2010 Apr 20;55(16):1671-8.
Gajos G, Rostoff P, Undas A, Piwowarska W.
Department of Coronary Disease, John Paul II Hospital, Cracow, Poland. ggajos@szpitaljp2.krakow.pl
OBJECTIVES: The purpose of this study was to investigate whether omega-3 polyunsaturated fatty acids (PUFAs) are able to modify platelet responsiveness to dual antiplatelet therapy in stable coronary artery disease patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Although previous studies have suggested antiplatelet properties of omega-3 polyunsaturated fatty acids, it is unknown whether they can enhance platelet inhibition on standard aspirin and clopidogrel treatment. METHODS: The OMEGA-PCI (OMEGA-3 Fatty Acids After PCI to Modify Responsiveness to Dual Antiplatelet Therapy) study was an investigator-initiated, prospective, single-center, double-blind, placebo-controlled, randomized study. Patients receiving standard dual antiplatelet therapy (aspirin 75 mg/day and clopidogrel 600 mg loading dose followed by 75 mg/day) were randomly assigned to receive the addition of 1 g of omega-3 ethyl esters (n = 33) or placebo (n = 30) for 1 month. Platelet function was measured serially by light transmission aggregometry (adenosine diphosphate and arachidonic acid [AA] were used as agonists) and assessment of the phosphorylation status of the vasodilator-stimulated phosphoprotein at baseline, 12 h, 3 to 5 days, and 30 days after randomization. RESULTS: The P2Y(12) reactivity index was significantly lower, by 22.2%, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo when used in addition to dual antiplatelet therapy (p = 0.020). Maximal platelet aggregation induced by 5 and 20 micromol/l adenosine diphosphate was lower by 13.3% (p = 0.026) and 9.8% (p = 0.029), respectively, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo. Platelet aggregation after AA stimulation was low and did not change significantly throughout the study. There were no cases of aspirin resistance during follow-up that was suggestive of good compliance with the medication. CONCLUSIONS: The addition of omega-3 ethyl esters to the combination of aspirin and clopidogrel significantly potentiates platelet response to clopidogrel after percutaneous coronary intervention. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Publication Types: Comparative Study Randomized Controlled Trial Research Support, Non-U.S. Gov't
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20394870&dopt=ExternalLink
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PMID: 20394870 [PubMed - indexed for MEDLINE]7: Clin Exp Hypertens. 2010 Jan;32(2):137-44.
Cicero AF, Derosa G, Di Gregori V, Bove M, Gaddi AV, Borghi C.
Lipid Research Unit, Department of Internal Medicine, Aging and Kidney Diseases, Alma Mater Studiorum University of Bologna, Bologna, Italy. afgcicero@cardionet.it
Recent evidence suggests that at least a part of the polyunsaturated fatty acids (PUFAs) heart protective effect is mediated by a relatively small but significant decrease in blood pressure level. We retrospectively evaluated the long-term effect of a PUFA supplementation on the blood pressure level of 111 hypertriglyceridemic subjects with untreated normal-high blood pressure that were prescribed a 2 grams PUFA supplementation in order to improve their plasma lipid pattern. After 12 months of treatment, systolic blood pressure (SBP) meanly decreased by 2.7 +/- 2.5 mmHg (p = 0.001) and diastolic blood pressure (DBP) by 1.3 +/- 3.3 mmHg (p < 0.001), while basal heart rate decreased by 4.0 +/- 4.4 bpm (p < 0.001). Both SBP and DBP reduction were significantly related to the baseline SBP (p < 0.001) and DBP (p < 0.001), respectively. Diastolic blood pressure change was also inversely related to the patient's age (p = 0.004). No significant difference was perceived in the metabolic syndrome subgroup. In our retrospective study, highly purified omega-3 PUFA long-term supplementation is associated with a significant reduction in SBP, DBP, Pulse pressure (PP), and basal heart rate in hypertriglyceridemic patients with normal-high blood pressure. No significant difference was perceived in the metabolic syndrome subgroup. The main determinants of the PUFA anti-hypertensive effect appear to be the basal blood pressure level and age.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20374188&dopt=ExternalLink
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PMID: 20374188 [PubMed - indexed for MEDLINE]8: Am Heart J. 2010 Apr;159(4):539-546.e2.
Geleijnse JM, Giltay EJ, Schouten EG, de Goede J, Oude Griep LM, Teitsma-Jansen AM, Katan MB, Kromhout D; Alpha Omega Trial Group.
Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. marianne.geleijnse@wur.nl
BACKGROUND: Weekly fish consumption has been related to a lower risk of fatal coronary heart disease (CHD) and incident stroke in populations with a low fish intake. This relation has mainly been attributed to n-3 fatty acids in fish, that is, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It is at present unclear whether alpha-linolenic acid (ALA), a n-3 fatty acid from vegetable origin, could also be protective against cardiovascular diseases (CVDs). There is a need for food-based trials to establish the efficacy of low doses of n-3 fatty acids in CVD prevention. OBJECTIVES: The aim of the study was to evaluate the effect of an additional daily intake of 400 mg of EPA + DHA and 2 g of ALA on CVD morbidity and mortality in free-living subjects with a history of myocardial infarction. DESIGN: The multicenter Alpha Omega Trial is a randomized, double-blind, placebo-controlled trial with a 2 x 2 factorial design. Between May 2002 and December 2006, we enrolled a total of 4,837 men and women aged 60 through 80 who experienced a myocardial infarction within 10 years before entering the study. Subjects were randomized to 1 of 4 margarine spreads that were enriched with EPA + DHA and/or ALA, or placebo. Compliance was monitored via tub counts and assessment of n-3 fatty acids in plasma. Subjects were observed for 40 months for the occurrence of fatal and nonfatal CVD. RESULTS: The cohort was on average 69 years old at the start of the study and comprised 22% women. Subjects had their (last) myocardial infarction approximately 4 years before enrolment. Mean body mass index was 27.7 kg/m(2), and 17% smoked. Average serum total and high-density lipoprotein cholesterol were 4.7 and 1.3 mmol/L, respectively, and 85% used statins. Mean blood pressure was 142/80 mm Hg, and most subjects were on antihypertensive medication (88%). Diabetes mellitus was reported by 17% of the subjects, and 7% reported a history of stroke. The overall mortality rate during the trial period was 23 per 1,000 person-years, with approximately 40% due to CVD. CURRENT STATUS: Follow-up of the patients was completed in November 2009, and findings will be reported in the second part of 2010. Copyright 2010 Mosby, Inc. All rights reserved.
Publication Types: Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20362710&dopt=ExternalLink
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PMID: 20362710 [PubMed - indexed for MEDLINE]9: Am J Obstet Gynecol. 2010 May;202(5):469.e1-6. Epub 2010 Mar 31.
Berman DR, Liu YQ, Barks J, Mozurkewich E.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI.
OBJECTIVE: Lipopolysaccharide pretreatment potentiates hypoxic ischemic injury. We hypothesized that docosahexaenoic acid pretreatment would improve function and reduce brain volume loss in this rat model of perinatal brain injury and inflammation. STUDY DESIGN: Seven-day-old rats were divided into 3 groups: intraperitoneal docosahexaenoic acid 1 mg/kg and lipopolysaccharide 0.1 mg/kg, 25% albumin and lipopolysaccharide, and normal saline. Injections were given 2.5 hours before carotid ligation, followed by 90 minutes 8% O2. Rats underwent sensorimotor function testing and brain volume loss assessment on postnatal day 14. RESULTS: Docosahexaenoic acid pretreatment improved vibrissae forepaw placing scores compared with albumin/lipopolysaccharide (mean+/-standard deviation weighted score/20: 17.72+/-0.92 docosahexaenoic acid/lipopolysaccharide vs 13.83+/-0.82 albumin/lipopolysaccharide; P<.007). Albumin/lipopolysaccharide rats scores were worse than those of the normal saline/normal saline rats (13.83+/-0.82 vs 17.21+/-0.71; P=.076). No significant differences in brain volume loss were observed among groups. CONCLUSION: Lipopolysaccharide inflammatory stimulation in conjunction with hypoxic ischemic resulted in poorer function than hypoxic ischemic alone. Docosahexaenoic acid pretreatment had significantly improved function in neonatal rats exposed to lipopolysaccharide and hypoxic ischemic. Copyright (c) 2010 Mosby, Inc. All rights reserved.
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PMID: 20356570 [PubMed - indexed for MEDLINE]10: J Nutr. 2010 May;140(5):1023-8. Epub 2010 Mar 24.
de Goede J, Geleijnse JM, Boer JM, Kromhout D, Verschuren WM.
Division of Human Nutrition, Wageningen University, 6700 EV, Wageningen, The Netherlands. janette.degoede@wur.nl
We assessed the dose-response relations within a low range of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and fish intake on fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI). In a Dutch population-based cohort study, EPA+DHA and fish intake were assessed at baseline among 21,342 participants aged 20-65 y with no history of MI or stroke. Hazard ratios were calculated with Cox proportional-hazard models. During 9-14 y of follow-up (mean 11.3 y), 647 participants (3%) died, of which 82 of CHD. Fatal CHD mainly comprised MI (64 cases). In total, 252 participants survived an MI. Median intakes in quartiles of EPA+DHA were 40, 84, 151, and 234 mg/d. Medians of fish consumption in quartiles were 1.1, 4.2, 10.7, and 17.3 g/d. Compared with the lowest quartile of EPA+DHA, participants in the top quartile had a 49% lower risk of fatal CHD (95% CI: 6-73%) and a 62% lower risk of fatal MI (95% CI: 23-81%). We observed inverse dose-response relations for EPA+DHA intake and fatal CHD (P-trend = 0.05) and fatal MI (P-trend = 0.01). Results were similar for fish consumption. Nonfatal MI was not associated with EPA+DHA or fish intake. In conclusion, in populations with a low fish consumption, EPA+DHA and fish may lower fatal CHD and MI risk in a dose-responsive manner. Low intakes of EPA+DHA or fish do not seem to protect against nonfatal MI.
Publication Types: Research Support, Non-U.S. Gov't
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20335635&dopt=ExternalLink
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PMID: 20335635 [PubMed - indexed for MEDLINE]11: Arch Cardiovasc Dis. 2010 Feb;103(2):106-14. Epub 2010 Feb 23.
Caspar-Bauguil S, Garcia J, Galinier A, Periquet B, Ferrieres J, Allenbach S, Morin N, Hericotte P, Salvayre R, Baudet M.
Laboratoire de biochimie, CHU de Rangueil, 1, avenue Jean-Poulhes, 31059 Toulouse cedex 9, France. casparbauguil.s@chu-toulouse.fr <casparbauguil.s@chu-toulouse.fr>
BACKGROUND: The outcome of coronary diseases is influenced by lifestyle and diet. Among dietary factors, n-3 polyunsaturated fatty acids reduce mortality from cardiovascular diseases. AIMS: To evaluate the impact of dietary and lifestyle advice by calculation of scores and analysis of plasmatic lipids and the fatty acid composition of erythrocyte membrane phospholipids after 1 year of patient education in 66 patients with acute coronary syndromes. METHODS: The answers given by patients during questioning were transformed into scores (atherosclerosis risk, dietary habits and global scores) at inclusion and after 1 year of follow-up. Classical metabolic risk factors and fatty acid composition of erythrocyte phospholipids were determined at the same time. RESULTS: After 1 year of education, patients improved their different scores, particularly by changing dietary habits. The positive impact was seen in the blood lipid and erythrocyte fatty acid levels: plasma low-density lipoprotein cholesterol and triglyceride concentrations were lowered and n-3 polyunsaturated fatty acid percentages were improved in phospholipids. CONCLUSION: Global score, lipid variables and the nature of the polyunsaturated fatty acids in erythrocyte phospholipids help us to evaluate patients with high coronary artery disease risk and the benefits of long-term dietary and lifestyle advice.
Publication Types: Controlled Clinical Trial
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PMID: 20226430 [PubMed - indexed for MEDLINE]12: Am J Clin Nutr. 2010 May;91(5):1317-23. Epub 2010 Mar 10.
Heine-Broring RC, Brouwer IA, Proenca RV, van Rooij FJ, Hofman A, Oudkerk M, Witteman JC, Geleijnse JM.
Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
BACKGROUND: Epidemiologic and experimental data suggest a cardioprotective effect of n-3 (omega-3) fatty acids from fish [eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)]. OBJECTIVE: The objective was to examine the association of fish and EPA plus DHA intakes with coronary calcification in a general older population. DESIGN: Diet was assessed between 1990 and 1993 by using a semiquantitative 170-item food-frequency questionnaire. Coronary calcification was assessed approximately 7 y later by electron-beam computed tomography in 1570 asymptomatic cardiac subjects with complete dietary data (44% men, mean age of 64 y). Calcium scores according to Agatston's method were divided into < or = 10 (no/minimal coronary calcification), 11-400 (mild/moderate calcification), and > 400 (severe calcification). Prevalence ratios (PRs) for mild/moderate and severe calcification were obtained in categories of fish and EPA plus DHA intake. PRs were adjusted for age, sex, body mass index, diabetes mellitus, socioeconomic status, smoking, alcohol intake, physical activity, and dietary factors. RESULTS: Subjects with a fish intake > 19 g/d had a significantly lower prevalence of mild/moderate calcification (PR: 0.87; 95% CI: 0.78, 0.98; full model) than did subjects who consumed no fish. Subjects with a high fish intake also had a lower prevalence of severe calcification (PR: 0.88; 95% CI: 0.74, 1.04), which was borderline statistically significant. EPA plus DHA intake showed no significant associations (PR: 0.93 and 0.97, respectively; P > 0.05). CONCLUSIONS: We found a weak inverse association between fish intake and coronary calcification. If confirmed in other population-based studies, more research is warranted to determine which components in fish can inhibit vascular calcification.
Publication Types: Research Support, Non-U.S. Gov't
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PMID: 20219958 [PubMed - indexed for MEDLINE]13: Am J Cardiol. 2010 Mar 15;105(6):844-8.
Berry JD, Prineas RJ, van Horn L, Passman R, Larson J, Goldberger J, Snetselaar L, Tinker L, Liu K, Lloyd-Jones DM.
Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical School, Dallas, Texas, USA. jarett.berry@utsouthwestern.edu
Experimental and clinical trial data have suggested an association between fish oil intake and atrial fibrillation (AF). However, previous observational studies have reported conflicting results regarding this association. Thus, we sought to compare the association between dietary fish intake and incident AF in a large sample of older, postmenopausal women. We included 44,720 participants from the Women's Health Initiative clinical trials who were not enrolled in the dietary modification intervention arm and without AF at baseline. The dietary intake of nonfried fish and omega-3 fatty acid intake was estimated from a Food Frequency Questionnaire at study entry. Incident AF was determined by follow-up electrocardiography at years 3 and 6. The baseline characteristics and rates of incident AF were compared across the quartiles of fish intake. Adjusted logistic regression models were used to evaluate the association between dietary nonfried fish intake and incident AF. A total of 378 incident cases of AF occurred during the follow-up period. In the age-adjusted models, no association was found between dietary nonfried fish intake and incident AF (odds ratio 1.17, 95% confidence interval 0.88 to 1.57 for quartile 4 vs quartile 1 of dietary fish intake). Similar findings were observed in the multivariate models and in the subgroup analyses. In conclusion, in a large cohort of healthy women, we found no evidence of an association between fish or omega-3 fatty acid intake and incident AF. Copyright 2010 Elsevier Inc. All rights reserved.
Publication Types: Multicenter Study Research Support, N.I.H., Extramural
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PMID: 20211329 [PubMed - indexed for MEDLINE]14: Prostaglandins Leukot Essent Fatty Acids. 2010 Apr-Jun;82(4-6):205-9. Epub 2010 Mar 6.
Sudheendran S, Chang CC, Deckelbaum RJ.
Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Cardiovascular disease is a leading cause of death worldwide. Atherosclerosis and unstable plaques are underlying causes for cardiovascular diseases. Cardiovascular disease is associated with consumption of diets high in saturated fats. In contrast there is increasing evidence that higher intakes of dietary n-3 fatty acids decrease risk for cardiovascular disease. Recent studies are beginning to clarify how n-3 compared with saturated fatty acids influence cardiovascular disease risk via pathways in the arterial wall. In this paper we will review studies that report on mechanisms whereby dietary fatty acids affect atherosclerosis through modulation of arterial wall lipid deposition, inflammation, cell proliferation, and plaque vulnerability. Copyright 2010 Elsevier Ltd. All rights reserved.
Publication Types: Research Support, N.I.H., Extramural Review
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PMID: 20207121 [PubMed - indexed for MEDLINE]15: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):110-30.
Marchioli R, Silletta MG, Levantesi G, Pioggiarella R, Tognoni G.
Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy. marchioli@negrisud.it
Over the past 20 years, there has been significant progress in our knowledge of the pathophysiology of heart failure (HF) with consequent considerable development of both pharmacological and non pharmacological approaches. Despite improved therapeutic strategies, HF still remains burdensome in terms of mortality, quality of life, and hospitalization costs. A new and promising medical treatment to improve survival in HF patients stems from the recent results of the Italian study, Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Heart Failure (GISSI-HF). GISSI-HF was a randomized, large scale, double-blind, placebo-controlled trial showing that n-3 PUFA (850-882 mg/d) reduced mortality and admission to the hospital for cardiovascular reasons in patients with chronic heart failure (HF) who were already receiving recommended therapies. The clinical benefit observed in GISSI-HF seemed to be mediated prominently by the antiarrhythmic effects of n-3 PUFA, though an effect on mechanisms related to HF progression cannot be excluded. This article presents the results of GISSI-HF study and reviews the previous clinical evidence on n-3 PUFA and risk of heart failure and discusses in depth the potential mechanisms through which n-3 PUFA treatment can improve clinical outcome in HF patients.
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PMID: 20196975 [PubMed - indexed for MEDLINE]16: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):93-101.
Von Schacky C.
Preventive Cardiology, Medizinische Klinik und Poliklinik Innenstadt, Ziemssenstrasse 1, Munich, Germany Clemens.vonschacky@med.uni-muenchen.de
Although statistically and clinically significant, reductions of clinical events seen in large scale intervention studies with omega-3 fatty acids in the cardiovascular field were smaller than would have been predicted from the results of epidemiologic studies. In epidemiologic studies, assessment of intake of fish or eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) predicted clinical events less well than assessing blood levels of EPA and DHA, e.g. by the Omega-3 Index. The Omega-3 Index is the percentage of EPA+DHA in red cell lipids, determined with a highly standardized methodology. Using the perspective of the Omega-3 Index facilitates reconciling discrepancies in results from intervention studies and from epidemiologic studies. Moreover, a low Omega-3 Index can be considered a risk factor for sudden cardiac death and for non-fatal cardiovascular events, whereas a high Omega-3 Index can be used as a therapeutic target. Currently ongoing and future scientific work on the basis of the Omega-3 Index will further define its value.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20196973&dopt=ExternalLink
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PMID: 20196973 [PubMed - indexed for MEDLINE]17: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):59-82.
Massaro M, Scoditti E, Carluccio MA, Campana MC, De Caterina R.
C.N.R. Institute of Clinical Physiology, Pisa, and Lecce, Italy.
Atherosclerosis is now widely accepted to be an inflammatory disease, characterized by degenerative as well as proliferative changes and extracellular accumulation of lipid and cholesterol, in which an ongoing inflammatory reaction plays an important role both in initiation and progression/destabilization, converting a chronic process into an acute disorder. Neovascularization has also been recognized as an important process for the progression/destabilization of atherosclerotic plaques. In fact, vulnerable atherosclerotic plaques prone to rupture are characterized by an enlarged necrotic core, containing an increased number of vasa vasorum, apoptotic macrophages, and more frequent intraplaque haemorrhage. Various functional roles have been assigned to intimal microvessels, however the relationship between the process of angiogenesis and its causal association with the progression and complications of atherosclerosis are still challenging and controversial. In the past 30 years, the dietary intake of omega-3 (n-3) polyunsaturated fatty acids--mainly derived from fish--has emerged as an important way to modify cardiovascular risk through beneficial effects on all stages of atherosclerosis, including plaque angiogenesis. This review specifically focuses on the modulating effects of n-3 fatty acids on molecular events involved in early and late atherogenesis, including effects on endothelial expression of adhesion molecules, as well as pro-inflammatory and pro-angiogenic enzymes. By accumulating in endothelial membrane phospholipids, omega-3 fatty acids have been shown to decrease the transcriptional activation of several genes through an attenuation of activation of the nuclear factor-kappaB system of transcription factors. This occurs secondary to decreased generation of intracellular reactive oxygen species. This series of investigations configures a clear example of nutrigenomics--i.e., how nutrients may affect gene expression, ultimately affecting a wide spectrum of human diseases.
Publication Types: Review
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20196971&dopt=ExternalLink
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PMID: 20196971 [PubMed - indexed for MEDLINE]18: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):45-51.
Eschen O, Christensen JH, LA Rovere MT, Romano P, Sala P, Schmidt EB.
Department of Cardiology, Center for Cardiovascular Research, Aalborg Sygehus, Aarhus University Hospital, Aalborg, Denmark. oe@dadlnet.dk
Inflammatory markers as circulating soluble cellular adhesion molecules (sCAMs) and high sensitive C-reactive protein (hsCRP) are elevated in patients with chronic heart failure (CHF), and may constitute an increased risk of adverse outcome. Marine n-3 polyunsaturated fatty acids ( n-3 PUFA) may have anti-inflammatory effect and reduce levels of sCAMs (soluble intercellular adhesion molecule-1 (sICAM-1), vascular adhesion molecule-1 (sVCAM-1), P-selectin) and hsCRP. In a randomized, controlled trial, 138 patients with NYHA class II-III CHF were allocated to receive a daily supplement of 0.9 g of n-3 PUFA or olive oil for 24 weeks. After supplementation, no significant changes occurred in sCAMs or hsCRP after adjusting for possible confounders. However, a significant reduction was observed in sP-selectin in patients receiving n-3 PUFA, but this result was only of borderline significance in a between-group analysis. In conclusion, a daily supplement with 0.9 g of n-3 PUFA does not significantly affect plasma levels of sCAMs or hs-CRP in patients with CHF. n-3 PUFA may reduce sP-selectin, indicating a possible effect on platelet (and endothelial) activation. The results also indicate that the low dose of n-3 PUFA used in many intervention trials does not have deleterious effects on sCAMs or hsCRP.
Publication Types: Randomized Controlled Trial Research Support, Non-U.S. Gov't
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20196969&dopt=ExternalLink
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PMID: 20196969 [PubMed - indexed for MEDLINE]19: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):28-37.
Calder PC, Yaqoob P.
Developmental Origins of Health and Disease Division and Institute of Human Nutrition, School of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK. pcc@soton.ac.uk
Long-chain n-3 polyunsaturated fatty acids are found in oily fish and in fish oils and similar preparations. Substantial evidence from epidemiological and case-control studies indicates that consumption of fish, oily fish and long-chain n-3 fatty acids reduces risk of cardiovascular mortality. Secondary prevention studies using long-chain n-3 fatty acids in patients post-myocardial infarction have shown a reduction in total and cardiovascular mortality with an especially potent effect on sudden death. Long-chain n-3 fatty acids have been shown to beneficially modify a range of cardiovascular risk factors, which may result in primary cardiovascular prevention. However, reduced non-fatal and fatal events and a reduction in sudden death probably involve other mechanisms. Reduced thrombosis following long-chain n-3 fatty acids may play a role. A decrease in arrhythmias is a favoured mechanism of action of long-chain n-3 fatty acids and is supported by cell culture and animal studies. However human trials using implantable cardiac defibrillators have produced inconsistent findings and a recent meta-analysis does not support this mechanism of action. An alternative mechanism of action may be stabilisation of atherosclerotic plaques by long-chain n-3 fatty acids. This is suggested by one published human study which showed that incorporation of long-chain n-3 fatty acids into plaques collected at carotid endarterectomy resulted in fewer macrophages in the plaque and a morphology indicative of increased stability. These findings are supported from observations in an animal model and suggest that the primary effect of long-chain n-3 fatty acids might be on macrophages within the plaque.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20196967&dopt=ExternalLink
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PMID: 20196967 [PubMed - indexed for MEDLINE]20: Cell Mol Biol (Noisy-le-grand). 2010 Feb 25;56(1):18-27.
Arnesen H, Seljeflot I.
Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Ulleval, Oslo, Norway. harald.arnesen@uus.no
Based on experience from randomised trials with n-3 PUFA we intend to answer some relevant questions in patients with coronary heart disease. In the SHOT study supplementation with 3.4 g/day of highly concentrated n-3 PUFA for 1 year significantly reduced the occlusion rate of venous aortocoronary bypass grafts, and this effect correlated significantly to the change in serum levels of n-3 fatty acids. In the CART study 5.1 g/day of highly concentrated n-3 PUFA did not reduce the incidence of restenosis after 6 months. If anything, a negative effect was observed. The background for this was probably a pro-oxidative and proinflammatory mechanism as elucidated in substudies. In the OVITES trial the addition of vitamin E did not counteract the proinflammatory effect of high amounts of n-3 PUFA supplementation as observed in CART, although circulating oxidative substances were unaffected. In the "Fiord-to-table" study replacement of fish oils by vegetable oils in the feed of farmed Atlantic salmon was mirrored in the fatty acid profile of the salmon fillets as well as in that of serum from patients after ingesting about 700 g/week for six weeks. A parallel reduction of the proinflammatory profile was observed only in patients who ingested salmon fed on fish oil.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20196966&dopt=ExternalLink
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PMID: 20196966 [PubMed - indexed for MEDLINE]