The impact of preexisting omega-3 fatty acid serum levels on outcomes following out-of-hospital cardiac arrest: A comprehensive investigation

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a medical challenge with persistently low survival rates. Omega-3 polyunsaturated fatty acids (PUFAs) confer cardiac and neuroprotection trough their anti-inflammatory and anti-oxidative effects. This prospective multicenter study aimed to evaluate the impact of pre-existing PUFA serum levels on OHCA survival and neurological outcome. METHODS: Blood samples were collected from OHCA patients immediately following the return of spontaneous circulation (ROSC) for the analysis of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) serum levels. Univariate and multivariate analyses incorporated demographic and resuscitation data. Follow-up assessments were conducted at 1, 6, 12 and 24 months post-OHCA. RESULTS: DHA levels after ROSC were significantly higher in patients who survived OHCA at 1 month and 12 months (p = 0.01 and p = 0.02, respectively). Similarly, EPA levels after ROSC were consistently higher in survivors across all follow-up time points (1 month: p = 0.04, 6 months: p = 0.03, 12 months: p < 0.001, 24 months: p = 0.03) compared to deceased patients at the corresponding time points. Multivariate analysis identified younger age (p = 0.03, OR 1.1), shorter no-flow time (p = 0.02, OR 1.3) and shorter cardiopulmonary resuscitation (CPR) duration (p = 0.02, OR 1.1) as strong predictors of survival following OHCA (numbers exemplarily for 12 months survival). Furthermore, the 77 % of survivors exhibited favorable neurological outcomes at 12 months post-OHCA. CONCLUSION: This study demonstrates a significant association between preexisting PUFA serum levels during OHCA and long-term outcomes following ROSC, highlighting their potential cardio- and neuroprotective roles. These findings underscore the need for further research to investigate potential therapeutic applications in the field of resuscitation.