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Effect of Omega-3 Fatty Acids on Coronary Plaque Morphology　- A Serial Computed Tomography Angiography Study

Sadako Motoyama1, Yasuomi Nagahara1, Masayoshi Sarai1

  • 1Department of Cardiology, Fujita Health University.

Circulation Journal : Official Journal of the Japanese Circulation Society
|November 15, 2021
PubMed

Insights

High-dose omega-3 fatty acids, specifically eicosapentaenoic acid (EPA), may reduce cardiac plaque progression in acute coronary syndrome (ACS) patients. Adding EPA to statin therapy showed a significant decrease in plaque progression compared to statins alone.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Imaging

Background:

  • Omega-3 fatty acids are investigated for cardiovascular event prevention.
  • High-risk plaque (HRP) and plaque progression on coronary computed tomography angiography (CTA) are linked to acute coronary syndrome (ACS).

Purpose of the Study:

  • To determine if omega-3 fatty acids (EPA/DHA) impact plaque characteristics in ACS patients undergoing secondary prevention with statins.
  • To assess changes in plaque characteristics using serial CTA when omega-3 fatty acids are added to statin therapy.

Main Methods:

  • 210 ACS patients were enrolled and categorized by eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dosage: none, low-dose EPA+DHA, high-dose EPA+DHA, and high-dose EPA alone.
  • Serial coronary computed tomography angiography (CTA) was used to assess high-risk plaque (HRP) and plaque progression.
  • Multivariate logistic regression analyzed predictors of plaque progression, including HRP, EPA dosage, and Rosvastatin use.

Main Results:

  • High-risk plaque (HRP) was more frequent in patients with plaque progression (P=0.0001).
  • A significant interaction between plaque progression and EPA dose was observed, with the highest EPA dose group showing the lowest progression rate (5.6%).
  • High-dose EPA (EPA-high) and Rosvastatin were independent predictors for reduced plaque progression (OR 0.13, P=0.0004 and OR 0.24, P=0.0079, respectively).
  • Quantitative analysis revealed a significant decrease in low attenuation plaque (LAP) volume in the EPA-high group, contrasting with an increase in the EPA-none group.

Conclusions:

  • In ACS patients, high-dose EPA added to statin therapy was associated with a reduced rate of plaque progression compared to statin therapy without EPA.
  • These findings suggest a potential benefit of high-dose EPA in stabilizing coronary artery plaque in patients with ACS.
Abstract

Keywords:
Acute coronary syndromeCoronary computed tomography angiographyEicosapentaenoic acidOmega-3 fatty acids

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