Omega-3-Fettsäuren in der Kardiologie - Neueste Entwicklungen
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| Autoren: | Prof. Dr. med. Clemens von Schacky, Medizinische Klinik und Poliklinik der Ludwig-Maximilians-Universität München und Omegametrix, Martinsried |
| ZUSAMMENFASSUNG |
| Die wesentlichen kardiologischen Fachgesellschaften auf der Welt empfehlen die beiden Omega-3 Fettsäuren Eicosapentaensäure (EPA) und Docosahexaensäure (DHA) zur Nachbehandlung nach Myokardinfarkt, zur Prävention des plötzlichen Herztodes und zur Prävention kardiovaskulärer Ereignisse. Die Empfehlungen beruhen auf einer umfassenden Datenlage, die in systematischen Reviews und Metaanalysen aufgearbeitet wurden. In epidemiologischen Arbeiten korrelierte der Gehalt eines Menschen an diesen beiden Omega-3 Fettsäuren invers mit der Wahrscheinlichkeit, den plötzlichen Herztod zu erleiden. Dieser Gehalt wird am besten durch den Omega-3 Index ausgedrückt, der den Gehalt der Erythrozyten an EPA und DHA erfasst. Der Omega-3 Index stellt sich so als Risikofaktor für den plötzlichen Herztod dar. Dies wird durch statistische Daten zum plötzlichen Herztod und durch die Ergebnisse von Interventionsstudien mit Omega-3-Fettsäuren gestützt. Der Omega-3 Index kann durch Aufnahme von Omega-3 Fettsäuren in einen Bereich steigen (> 8%), der den plötzlichen Herztod um 90% unwahrscheinlicher macht als der bei uns gängige Bereich (< 4%). Methodische Aspekte und analytische Probleme legen es nahe, den Omega-3 Index in einem hierfür ausgewiesenen Labor zu bestimmen. |
| Schlüsselwörter: | Myokardinfarkt, Omega-3 Fettsäuren, Plötzlicher Herztod, Prävention, Omega-3 Index |
| MMW-Fortschritte der Medizin Originalien Nr. III/2007 (149. Jg.), S. 97-101 |
| Fazit: |
Die beiden Omega-3-Fettsäuren EPA+DHA sind sicher und effektiv in der Prophylaxe des plötzlichen Herztodes, in der Nachbehandlung nach Myokardinfarkt oder in der kardiovaskulären Prävention. Die Gesamtmortalität wird um 17% gesenkt, was den Effekt der Statine übersteigt [13, 14]. Dies gilt insbesondere für die Verwendung von Quellen der Omega-3 Fettsäuren, die frei von Kontaminanten sind, wie hochwertige Fischöle. Der Omega-3 Index stellt sich als Risikofaktor für den plötzlichen Herztod dar und scheint bisher bekannten Risikofaktoren überlegen. Eine Therapie mit Omega-3-Fettsäuren kann mit dem Omega-3-Index kontrolliert und gesteuert werden. |
| PDF: | Omega-3-Fettsäuren in der Kardiologie - Neueste Entwicklungen |
Omega-3 Fatty Acids and Cardiac Arrhythmias: Prior Studies and Recommendations for Future Research: A Report from the National Heart, Lung, and Blood Institute and Office of Dietary Supplements Omega-3 Fatty Acids and Their Role in Cardiac Arrhythmogenesis Workshop
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| Autoren: | Barry London, Christine Albert, Mark E. Anderson, Wayne R. Giles, David R. Van Wagoner, Ethan Balk, George E. Billman, Mei Chung, William Lands, Alexander Leaf, John McAnulty, Jeffrey R. Martens, Rebecca B. Costello and David A. Lathrop |
| Excerpt: | Future randomized trials should feature the following: Patient selection and follow-up should include clinically relevant biological parameters and markers (eg, plasma and cellular n-3 fatty acid levels and markers of systemic inflammation, redox state, or oxidative stress). |
Circulation 2007;116;e320-e335 DOI: 10.1161/CIRCULATIONAHA.107.712984
Circulation is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TX 72514 |
| Copyright: | Copyright © 2007 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539 |
| The online version of this article, along with updated information and services, is located on the World Wide Web at: http://circ.ahajournals.org/cgi/content/full/116/10/e320 |
Comparison between plasma and erythrocyte fatty acid content as biomarkers of fatty acid intake in US women.
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| Autoren: |
Qi Sun, Jing Ma, Hannia Campos, Susan E Hankinson, and Frank B Hu |
| ABSTRACT: |
| Background: |
Erythrocyte fatty acids may be superior to plasma fatty acids for reflecting long-term fatty acid intake because of less sensitivity to recent intake and a slower turnover rate. |
| Objective: |
The objective was to compare the fatty acid content of erythrocytes with that of plasma with respect to their abilities to reflect usual fatty acid intake. |
| Design: |
Fatty acids in plasma and erythrocytes were measured by capillary gas-liquid chromatography in 306 US women aged 43-69y. Fatty acid intake was assessed with a food-frequency question- naire, which was validated for measuring intakes of various fatty acids. |
| Results: |
Docosahexaenoic acid (DHA, 22:6n 3) in erythrocytes and plasma provided the strongest correlations with its intake, but erythrocyte DHA concentrations [Spearman's partial correlation co- efficient (rs) 0.56] were better than plasma DHA concentrations (rs 0.48) as a biomarker. Total trans fatty acids (rs 0.43) and total 18:1 trans isomers (rs 0.42) in erythrocytes were also more strongly correlated with intake than were those in plasma (rs 0.30 and rs 0.29, respectively). Moderate correlations were observed for linoleic acid (18:2n 6; erythrocytes, rs 0.24; plasma, rs 0.25), -linolenic acid (18:3n 3; erythrocytes, rs 0.18; plasma, rs 0.23), and eicosapentaenoic acid (20:5n 3; erythrocytes, rs 0.38; plasma, rs 0.21). For polyunsaturated and trans fatty acids, correlations between intakes and biomarkers improved moderately when average intakes over previous years were used. |
| Conclusion: |
Erythrocyte n 3 fatty acids of marine origin and trans fatty acid content are suitable biomarkers for long-term intake. |
| Am J Clin Nutr 2007;86:74-81. |
| Keywords: | Fatty acids, erythrocytes, plasma, biological markers, food-frequency questionnaires, US women |
| The online version of this article, along with updated information and services, is located on the World Wide Web at: http://www.ajcn.org/cgi/content/abstract/86/1/74 |
EPA and DHA in blood cell membranes from acute coronary syndrome patients and controls. Atherosclerosis. 2008;197:821-8
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| Autoren: |
Block RC, Harris WS, Reid KJ, Sands SA and Spertus JA |
| Place: |
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, Box 644, 601 Elmwood Avenue, NY 14642, United States. robert block@urmc.rochester.edu |
| ABSTRACT: |
| Background: |
Increased blood levels of the omega-3 fatty acids (FA) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been inversely associated with risk for sudden cardiac death, but their relationship with acute coronary syndromes (ACS) is unclear. OBJECTIVE: We hypothesized that the EPA+DHA content of blood cell membranes, as a percent of total FAs, is reduced in ACS patients relative to matched controls. |
| METHODS: |
We measured the content of EPA+DHA in 768 ACS patients and 768 age-, sex- and race-matched controls. The association with ACS case status of blood cell EPA+DHA [both by a 1 unit change and by category (low, <4%; intermediate 4.1-7.9%; and high, > or =8%)] was assessed using multivariate conditional logistic regression models adjusting for matching variables and smoking status, alcohol use, diabetes, body mass index, serum lipids, education, family history of coronary artery disease, personal histories of myocardial infarction and hypertension, and statin, aspirin, and other antiplatelet drug use. |
| RESULTS: |
The combined groups had a mean age of 61+/-12 years, 66% were male, and 92% were Caucasian. The EPA+DHA content was 20% lower in cases than controls (3.4+/-1.6 vs. 4.25+/-2.0%, p<0.001). The multivariable-adjusted odds for case status was 0.77 (95% CI 0.70 to 0.85, p<0.001) for a 1 unit increase in EPA+DHA content. Compared with the lowest EPA+DHA group, the odds ratio for an ACS event was 0.58 (95% CI 0.42-0.80), in the intermediate EPA+DHA group and was 0.31 (95% CI 0.14-0.67; p for trend <0.0001) in the highest EPA+DHA group. |
| CONCLUSIONS: |
Odds for ACS case status increased incrementally as the EPA+DHA content decreased suggesting that low EPA+DHA may be associated with increased risk for ACS. |
| Link: |
http://linkinghub.elsevier.com/retrieve/pii/S0021-9150(07)00476-5 |
