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Polyunsaturated Fatty Acids Improved Long Term Prognosis by Reducing Oxidative Stress, Inflammation, and Endothelial
Alexandru Covaciu1,2, Theodora Benedek1, Elena Bobescu2,3
1M3 Department-Clinical and Medical-Surgical Disciplines, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology from Târgu Mureș, 540139 Târgu Mureș, Romania.
Insights
Omega-3 fatty acids therapy significantly reduced oxidative stress, inflammation, and endothelial dysfunction in acute coronary syndromes (ACS). This improved long-term prognosis, lowering risks of cardiovascular events and death.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Biochemistry
Background:
- Oxidative stress, inflammation, and endothelial dysfunction are key drivers of atherosclerosis and acute coronary syndromes (ACS).
- Omega-3 polyunsaturated fatty acids (Omega-3 PUFAs), found in marine sources, possess properties that can mitigate these pathological processes.
- Supplementation with Omega-3 PUFAs may offer a therapeutic strategy to reduce atherosclerosis progression and ACS incidence.
Purpose of the Study:
- To investigate the impact of Omega-3 PUFAs therapy on oxidative stress, inflammatory markers, and endothelial function in ACS patients.
- To assess the long-term clinical outcomes and prognosis associated with Omega-3 PUFAs supplementation in ACS.
Main Methods:
- A prospective study involving 1140 ACS patients, divided into four groups receiving Omega-3 PUFAs plus optimal medical therapy (OMT) or OMT alone.
- Evaluated changes in oxidative stress (TAS, Ab anti-ox-LDL, IgG anti-MPO), inflammatory markers (CRP, fibrinogen), and endothelial function (FMD, vWf activity) over 6 months.
- Monitored 5-year clinical events, including cardiovascular death, ACS recurrence, stroke, and heart failure readmissions.
Main Results:
- Omega-3 PUFAs, when added to OMT, significantly reduced markers of oxidative stress, inflammation, and endothelial dysfunction at 6 months.
- Patients treated with Omega-3 PUFAs showed a significant reduction in the risk of cardiovascular death and sudden death.
- A decreased incidence of recurrent ACS, in-stent restenosis, stroke, and heart failure readmissions was observed in the Omega-3 PUFA-treated groups.
Conclusions:
- Therapy with Omega-3 PUFAs, as an adjunct to OMT, effectively improves biochemical parameters related to cardiovascular risk in ACS patients.
- Omega-3 PUFAs supplementation leads to a significant enhancement of long-term prognosis in individuals with acute coronary syndromes.
- The findings support the use of Omega-3 PUFAs in managing ACS to reduce both subclinical disease markers and major adverse cardiovascular events.
Background:
Oxidative stress, inflammation, and endothelial dysfunction are important processes in the progression of atherosclerosis and the occurrence of acute coronary syndromes (ACSs). Omega-3 polyunsaturated fatty acids (Omega-3 PUFAs) are present in marine organisms and have the capacity to reduce all these processes and, at the same time, the progression of atherosclerosis and the emergence of ACSs.
Aim:
To evaluate the role of Omega-3 PUFAs therapy on parameters of oxidative stress, inflammatory syndrome, endothelial dysfunction, and long-term prognosis in acute coronary syndromes.
Methods:
One thousand one hundred forty patients were admitted to Clinic County Emergency Hospital Brasov with ACS and were enrolled in a prospective study. The study was divided into four groups related to the type of ACS and treatment with Omega-3 PUFAs added to the optimal medical therapy (OMT). The effect of Omega-3 PUFAs therapy associated with the OMT was determined by measuring the dynamics of the following parameters: (a) oxidative stress-total antioxidant status (TAS), oxidated low density lipoprotein cholesterol antibodies (Ab anti-ox-LDL), IgG anti-Myeloperoxidase antibodies (IgG type Ab anti-MPO); (b) inflammatory syndrome-C-reactive protein and fibrinogen; (c) endothelial dysfunction-flow mediated dilation (FMD) and von Willebrand factor (vWf) activity, from baseline to 6 months of follow-up. Clinical events followed at 5 years were cardiovascular and sudden death, Non-ST and ST segment elevation ACS, in stent thrombosis and restenosis, stroke, readmission in hospital for ACS and for heart failure.
Results:
In ACS groups, treatment with Omega-3 PUFAs added to the OMT significantly decreased the parameters of oxidative stress, inflammatory syndrome, and endothelial dysfunction at 6 months of follow-up. Regarding the clinical events, a significant reduction in the risk of cardiovascular and sudden death and a decreased incidence of Non-ST and ST segment elevation ACS, in-stent restenosis, readmission for ACS and heart failure, was observed in Omega-3 PUFA-treated groups in comparison to control groups.
Conclusions:
In acute coronary syndromes, therapy with Omega-3 PUFAs added to the OMT resulted in a significant decrease of parameters of oxidative stress, inflammation, and endothelial dysfunction at 6 months and also a significant improvement in the long-term prognosis.
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