OBJECTIVES Coronary artery calcification (CAC) can reliably predict cardiovascular events. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are thought to inhibit vascular calcification on a cellular level and in animal models, however, the correlation in humans is controversial. METHODS In symptomatic patients, CAC was quantified according to Agatstons' method using non-contrast coronary CT. We assessed the association of EPA and DHA with early-onset coronary atherosclerosis, defined as presence of CAC above the 75th Agatston-Score (AS) percentile in sex adjusted age categories. Erythrocyte fatty acid composition was analyzed with a standardized methodology. The percentage of EPA and DHA in relation to all fatty acids present in the erythrocyte membrane is regarded the Omega-3 Index®. RESULTS Among 71 patients, 51 were below and 20 were above the 75th AS-percentile. No differences were seen in age, gender, cardiovascular risk factors, and relevant medication. In univariable analysis, significantly lower values for EPA (0.77%[0.63; 0.97] vs. 0.93%[0.72; 1.21]; p = 0.045), DHA (4.90%[4.12; 5.57] vs. 5.50%[4.58; 6.52]; p = 0.038) and the Omega-3 Index (5.73%[4.75; 6.35] vs. 6.22%[5.46; 7.71]; p = 0.034) were seen in patients above the 75th AS-percentile. All other fatty acids showed no significant differences. In multivariable analysis, the Omega-3 Index showed a significant inverse association with early onset of CAC (OR: 0.533 (95%CI: 0.303-0.938; p = 0.029)), independent of age, gender, statin use, and creatinine level (all p > 0.05). CONCLUSIONS Low levels of EPA and DHA (Omega-3 Index) are associated with early-onset coronary atherosclerosis. This finding needs to be validated in larger cohorts and might help understand the beneficial cardiovascular effects of omega-3 fatty acids.

中文翻译：

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omega-3脂肪酸含量低的患者的早发性冠状动脉粥样硬化。

目的冠状动脉钙化（CAC）可以可靠地预测心血管事件。人们认为二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）在细胞水平和动物模型中均能抑制血管钙化，但在人类中的相关性尚存争议。方法在有症状的患者中，根据Agatstons的方法使用非对比冠状动脉CT对CAC进行定量。我们评估了EPA和DHA与早发性冠状动脉粥样硬化的相关性，后者定义为在性别调整的年龄类别中高于第75个Agatston-Score（AS）百分位的CAC。用标准化方法分析红细胞脂肪酸组成。EPA和DHA相对于红细胞膜中所有脂肪酸的百分比被视为Omega-3Index®。结果71例患者中，在第75个AS百分位数以下，其中51个低于20％。在年龄，性别，心血管危险因素和相关用药方面未见差异。在单变量分析中，EPA（0.77％[0.63; 0.97]对0.93％[0.72; 1.21]； p = 0.045），DHA（4.90％[4.12; 5.57]对5.50％[4.58; 6.52] ；第75个AS百分位数以上的患者中观察到Omega-3指数（5.73％[4.75; 6.35]对6.22％[5.46; 7.71]； p = 0.034）和Omega-3指数。所有其他脂肪酸均无明显差异。在多变量分析中，Omega-3指数与CAC的早期发作呈显着负相关（OR：0.533（95％CI：0.303-0.938； p = 0.029）），与年龄，性别，他汀类药物的使用和肌酐水平无关（所有p> 0.05）。结论EPA和DHA（Omega-3指数）水平低与早发性冠状动脉粥样硬化有关。