The balance of omega-3 polyunsaturated fatty acids for -reducing residual risks in patients with coronary artery disease

Abstract

Residual risk, which cannot be prevented by statins alone, must be controlled for inhibiting the onset of coronary events. Omega-3 polyunsaturated fatty acids (PUFAs) play an important role in controlling residual risk. The Japan eicosapentaenoic acid (EPA) Lipid Intervention Study demonstrated the inhibitory effect of high-purity EPA preparations on the residual risk of cardiovascular events. Omega-3 PUFAs inhibit coronary artery disease (CAD) through various actions, including triglyceride-lowering action. Besides lipid metabolism, platelet aggregation inhibition, anti-inflammatory effects, improved vascular endothelium function, and anti-hypertensive action contribute to arteriosclerosis inhibition. Conversely, several recent studies did not demonstrate the efficacy of omega-3 PUFAs for CAD prevention. PUFAs levels may need to exceed a threshold for anti-arteriosclerotic action. The efficacy of EPA might depend on the baseline value of the EPA/arachidonic acid (AA) ratio prior to EPA administration. This baseline EPA/AA ratio value varies according to country and region as well as changes of dietary habits. More global research in this field is needed to identify an optimal omega-3 PUFAs administration strategy.

Keywords:

• Arachidonic acid
• coronary artery disease
• docosahexaenoic acid
• eicosapentaenoic acid
• eicosapentaenoic acid to arachidonic acid ratio (EPA/AA ratio)
• omega-3 polyunsaturated fatty acids (PUFAs)

ACKNOWLEDGEMENT

We express our gratitude to the librarian, Ms. Michiko Takahashi, for her assistance in the collection of literature for the present study.

CONFLICT OF INTEREST

KS received lecture fees from Mochida Pharmaceutical Company and Takeda Pharmaceutical Company. HD received scholarship funds and lecture fees from Mochida Pharmaceutical Company and Takeda Pharmaceutical Company.