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Association Between Omega-3 Fatty Acid Levels and Aortic Valve Calcium (from the Multi-Ethnic Study of
Anthony D Pisaniello1, Abdulhamied Alfaddagh2, Martin Tibuakuu2
1Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Discipline of Medicine, The University of Adelaide, Adelaide, Australia.
Insights
Omega-3 fatty acids (O3FAs) do not predict the presence or progression of aortic valve calcium (AVC) in individuals not taking O3FA supplements. Further research is needed on high-dose O3FA supplementation and its association with AVC.
Area of Science:
- Cardiovascular Science
- Nutritional Science
- Radiology
Background:
- Calcific aortic valve disease (CAVD) is linked to inflammation and increased mortality.
- Omega-3 fatty acids (O3FAs) possess anti-inflammatory properties.
- The relationship between O3FAs and aortic valve calcium (AVC) remains unstudied.
Purpose of the Study:
- To investigate the association between plasma O3FA levels and the presence, severity, and progression of AVC.
- To determine if O3FAs can serve as biomarkers for AVC in a general population.
Main Methods:
- Utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
- Measured plasma fatty acid levels and performed cardiac computed tomography (CT) scans over a median 9-year follow-up.
- Assessed baseline AVC, incident AVC, and AVC change in relation to O3FA plasma tertiles.
Main Results:
- Plasma levels of eicosapentaenoic acid, docosahexaenoic acid, and total O3FAs were not associated with prevalent AVC at baseline.
- O3FA levels did not correlate with incident AVC or the change in AVC over time.
- Participants with prevalent AVC were older, male, White, and had more comorbidities.
Conclusions:
- Plasma O3FA levels in individuals not routinely supplemented are not predictive of AVC presence or development.
- The role of high-dose O3FA supplementation or pharmacotherapy in AVC requires further investigation.
Abstract:
Calcific aortic valve disease, a condition of chronic inflammation, is associated with increased cardiovascular events and all-cause mortality. Omega-3 fatty acids (O3FAs) reduce both acute and chronic inflammation, but their associations with aortic valve calcium (AVC) have not been studied. The Multi-Ethnic Study of Atherosclerosis is a prospective cohort study of 6,814 adults without clinical cardiovascular disease. Plasma fatty acid levels and cardiac computed tomography (CT) scans were performed at baseline, and CT scans were performed at subsequent clinical visits over a median 9-year period. We assessed whether plasma levels of O3FAs and their species correlate with the presence, severity, and progression of AVC measured by CT in Multi-Ethnic Study of Atherosclerosis. The mean age of the 6,510 included participants with baseline fatty acid levels, AVC, and covariate data was 62.1 ± 10.2 years, and 47.1% of the participants were male. Race distribution was 38.6% White, 27.2% Black, 22.1% Hispanic/Latino, and 12.1% Chinese. Among the 6,510 participants, 5,884 had a subsequent CT scan, and 3,304 had a third CT scan with AVC measurements. At baseline, 862 participants (13.2%) had prevalent AVC (Agatston score >0), and were more likely to be of older age, male, of the White race, have a lower education level, and have co-morbidities that are associated with a higher risk for AVC. Plasma tertiles of eicosapentaenoic acid, docosahexaenoic acid, and total O3FA were not associated with prevalent AVC at baseline, incident AVC, or change in AVC. In conclusion, plasma levels of O3FAs in subjects not routinely supplemented with O3FAs are not useful for predicting the presence or development of AVC. Whether high plasma O3FA levels, achievable by high-dose O3FA over-the-counter supplementation or pharmacotherapy, is associated with AVC requires further investigation.
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