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The effect of omega-3 fatty acids on coronary atherosclerosis quantified by coronary computed tomography angiography
Gudrun Feuchtner1, Christian Langer1, Fabian Barbieri2
1Department of Radiology, Innsbruck Medical University, Austria.
Insights
Omega-3 fatty acid supplementation reduced high-risk coronary plaque and non-calcified plaque burden in patients. This suggests direct anti-atherogenic effects of omega-3 polyunsaturated fatty acids (PUFA) in preventing coronary artery disease.
Area of Science:
- Cardiology
- Nutritional Science
- Medical Imaging
Background:
- Contradictory data exist on omega-3 fatty acids' effects on coronary artery disease (CAD).
- While some studies show no cardiovascular benefits, known anti-atherogenic mechanisms support their potential role.
- Omega-3 polyunsaturated long-chain fatty acids (PUFA) include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
Purpose of the Study:
- To evaluate the impact of omega-3 PUFA supplementation on coronary atherosclerosis.
- Quantification of coronary atherosclerosis was performed using coronary computed tomography angiography (CTA).
Main Methods:
- 106 patients with low-to-intermediate cardiovascular risk were included.
- 53 patients on omega-3 PUFA were propensity score matched with 53 controls based on risk factors and lifestyle.
- CTA assessed stenosis severity, total plaque burden (SIS, G-score), and high-risk-plaque features; plaque density (HU) was measured.
Main Results:
- No significant difference in overall coronary atherosclerosis prevalence or stenosis severity between groups.
- Omega-3 group showed lower total non-calcified plaque burden (G-score, p=0.027).
- Significantly lower prevalence of high-risk plaques (p<0.001) and Napkin-Ring Sign (p<0.001) in the omega-3 group, with higher plaque density (p=0.02) indicating more fibrous plaque.
Conclusions:
- Omega-3 PUFA supplementation is linked to reduced coronary atherosclerotic high-risk plaque and lower non-calcified plaque burden.
- Findings suggest direct anti-atherogenic effects of omega-3 PUFA, independent of traditional cardiovascular risk factors.
- The study supports a beneficial role for omega-3 PUFA in managing atherosclerosis.
Background & Aims:
Data on the effects omega-3 fatty acids on coronary artery disease (CAD) are contradictory. While a recent metanalysis could not show improved cardiovascular outcomes, anti-atherogenic mechanisms are well known.
Objective:
Aim was to assess the influence of Omega-3 polyunsaturated long-chain fatty acids (PUFA) supplementation on coronary atherosclerosis quantified by coronary computed tomography angiography (CTA).
Methods:
106 patients (59.4y± 10.7; 50% females) with low-to-intermediate risk referred to CTA were included. 53 patients under omega 3-PUFA (docosahexaenoic acid, DHA and eicosapentaenoic acid, EPA) supplementation were retrospectively matched with 53 controls (CR) for age, gender and coronary risk profile (smoking, arterial hypertension, family history, dyslipidemia, c-LDL, Cholesterol, TG, diabetes) (1:1, propensity score) and lifestyle habits (exercise, alcohol consumption and nutrition). CTA analysis included 1) stenosis severity score >70%severe, 50-70% moderate, 25-50%mild, <25% minimal), 2) total plaque burden (segment involvement score (SIS) and mixed non-calcified plaque burden (G-score) and 3) high-risk-plaque features (Napkin-Ring-Sign, low attenuation plaque (LAP), spotty calcification<3 mm, RI>1.1). CT-Density (Hounsfield Units, HU) of plaque was quantified by CTA.
Results:
Prevalence of coronary atherosclerosis (any plaque: 83% vs. 90.6%, p = 0.252), >50% stenosis and stenosis severity score (p = 0.134) were not different between groups. Total and non-calcified plaque burden scores were lower in the omega-3 group (2.7 vs. 3.5, p = 0.08 and 4.5 vs. 7.4, p = 0.027 for SIS and G-score, resp.). Coronary artery calcium score (CACS) was similar (84.7 vs. 87.1AU). High-risk-plaque prevalence was lower in the Omega-3 group (3.8% vs. 32%, p < 0.001); the number of high-risk-plaques (p < 0.001) and Napkin-Ring-Sign prevalence was lower (3.8% vs. 20.9%) (p < 0.001), resp. CT-density (HU) of plaque was higher in the Omega-3 group (131.6 ± 2 vs. 62.1 ± 27, p = 0.02) indicating more fibrous-dense plaque component rather than lipid-rich atheroma. Mean duration of Omega-3 intake was 38.6 ± 52 months (range, 2-240).
Conclusions:
Omega-3-PUFA supplementation is associated with less coronary atherosclerotic "high-risk" plaque (lipid-rich) and lower total non-calcified plaque burden independent on cardiovascular risk factors. Our study supports direct anti-atherogenic effects of Omega-3-PUFA.
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