Key result
Pre-STEMI omega-3 intake below 1.7g linked to ~96% higher risk of hs-CRP elevation and adverse remodeling.
Why the study?
Excessive acute post-MI inflammation promotes adverse remodeling and mortality, but whether anti-inflammatory omega-3 intake attenuates this response and subsequent cardiac remodeling was unclear.
Is dietary omega-3 intake associated with attenuated inflammatory response and cardiac remodeling in patients with STEMI?
Cohort (n=421)
No
Is dietary omega-3 intake associated with attenuated inflammatory response and cardiac remodeling in patients with STEMI?
Odds Ratio: 1.96 (95% CI 1.24–3.1)
p-value: p=0.004
Reduced daily intake of omega-3 prior to STEMI is associated with an intensified acute inflammatory response and worse late left ventricular remodeling.
BACKGROUND: Myocardial infarction (MI) elicits an intense acute inflammatory response that is essential for cardiac repair. However, an excessive inflammatory response also favors myocardial apoptosis, cardiac remodeling, and cardiovascular mortality. Omega-3 polyunsaturated fatty acids (ω-3) bear anti-inflammatory effects, which may mitigate the inflammatory response during MI. This study investigated whether ω-3 intake is associated with attenuation of the MI-related inflammatory response and cardiac remodeling. METHODS: ST-elevation MI (STEMI) patients (n = 421) underwent clinical, biochemical, nutritional, 3D echocardiogram, Cardiac Magnetic Resonance imaging (CMRi) at 30 days and 3D echocardiogram imaging at six months after the MI. Blood tests were performed at day one (D1) and day five (D5) of hospitalization. Changes in inflammatory markers (ΔD5-D1) were calculated. A validated food frequency questionnaire estimated the nutritional consumption and ω-3 intake in the last 3 months before admission. RESULTS: The intake of ω-3 below the median (< 1.7 g/day) was associated with a short-term increase in hs-C-reactive protein [OR:1.96(1.24-3.10); p = 0.004], Interleukin-2 [OR:2.46(1.20-5.04); p = 0.014], brain-type natriuretic peptide [OR:2.66(1.30-5.44); p = 0.007], left-ventricle end-diastolic volume [OR:5.12(1.11-23.52)]; p = 0.036] and decreases in left-ventricle ejection fraction [OR:2.86(1.47-6.88); p = 0.017] after adjustment for covariates. No differences were observed in the extension of infarcted mass obtained by CMRi. CONCLUSION: These findings suggest that a reduced daily intake of ω-3 may intensify outcome-determining mechanisms after STEMI, such as acute inflammatory response and late left ventricular remodeling. TRIAL REGISTRATION: Clinical Trial Registry number and website: NCT02062554 .
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Campos‐Staffico et al. (2019) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=421). Omega-3 intake vs. Intake above the median (≥ 1.7 g/day) was evaluated on Short-term increase in hs-C-reactive protein (Δhs-CRP ≥ +2.20 mg/L) (OR 1.96, 95% CI 1.24-3.10, p=0.004). Daily omega-3 intake below 1.7 g prior to ST-elevation myocardial infarction was associated with a significantly higher risk of short-term increase in hs-CRP (OR 1.96) and adverse cardiac remodeling.
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