Predictors of endothelial function improvement in patients with mild hypertriglyceridemia without evidence of coronary artery disease treated with purified eicosapentaenoic acid.


Journal

Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543

Informations de publication

Date de publication:
09 2020
Historique:
received: 24 12 2018
revised: 27 06 2020
accepted: 15 07 2020
pubmed: 30 8 2020
medline: 24 6 2021
entrez: 30 8 2020
Statut: ppublish

Résumé

Eicosapentaenoic acid (EPA) has been reported to reduce cardiovascular risk in patients with hypertriglyceridemia. Although several mechanisms underlying the effects of EPA have been demonstrated, those responsible for its beneficial role in patients with hypertriglyceridemia without evidence of coronary artery disease (CAD) have not been fully elucidated. We sought to clarify the main factors associated with EPA administration that led to improved endothelial function. Forty-seven consecutive patients with mild hypertriglyceridemia (mean age, 59 ± 13 years) without evidence of CAD were prospectively enrolled and administered purified EPA (1800 mg/day). Forty-four patients who were not administered EPA were enrolled as age- and sex-matched controls. Clinical variables and flow-mediated dilation (FMD) were examined before and after 6 months of treatment. Univariate and multivariate regression analyses were performed between FMD changes and clinical variables. EPA treatment decreased triglyceride levels (from 224.6 ± 58.8 to 151.8 ± 54.5 mg/dl, p < 0.001) and increased FMD (from 4.21% ± 1.91% to 6.21% ± 2.30%, p < 0.001). Multivariate analysis showed that the change in FMD was associated with the baseline high-density lipoprotein cholesterol (HDL-C) level (β = -0.331, p = 0.027) and the change in EPA/arachidonic acid (AA) ratio (β = 0.301, p = 0.048). EPA treatment improved triglyceride levels and FMD in patients with mild hypertriglyceridemia and without evidence of CAD. The baseline HDL-C level and the change in EPA/AA ratio predicted FMD improvement. The beneficial effects of EPA on triglyceride-rich lipoproteins and vascular endothelium may help improve endothelial function.

Sections du résumé

BACKGROUND AND AIMS
Eicosapentaenoic acid (EPA) has been reported to reduce cardiovascular risk in patients with hypertriglyceridemia. Although several mechanisms underlying the effects of EPA have been demonstrated, those responsible for its beneficial role in patients with hypertriglyceridemia without evidence of coronary artery disease (CAD) have not been fully elucidated. We sought to clarify the main factors associated with EPA administration that led to improved endothelial function.
METHODS
Forty-seven consecutive patients with mild hypertriglyceridemia (mean age, 59 ± 13 years) without evidence of CAD were prospectively enrolled and administered purified EPA (1800 mg/day). Forty-four patients who were not administered EPA were enrolled as age- and sex-matched controls. Clinical variables and flow-mediated dilation (FMD) were examined before and after 6 months of treatment. Univariate and multivariate regression analyses were performed between FMD changes and clinical variables.
RESULTS
EPA treatment decreased triglyceride levels (from 224.6 ± 58.8 to 151.8 ± 54.5 mg/dl, p < 0.001) and increased FMD (from 4.21% ± 1.91% to 6.21% ± 2.30%, p < 0.001). Multivariate analysis showed that the change in FMD was associated with the baseline high-density lipoprotein cholesterol (HDL-C) level (β = -0.331, p = 0.027) and the change in EPA/arachidonic acid (AA) ratio (β = 0.301, p = 0.048).
CONCLUSIONS
EPA treatment improved triglyceride levels and FMD in patients with mild hypertriglyceridemia and without evidence of CAD. The baseline HDL-C level and the change in EPA/AA ratio predicted FMD improvement. The beneficial effects of EPA on triglyceride-rich lipoproteins and vascular endothelium may help improve endothelial function.

Identifiants

pubmed: 32861211
pii: S0021-9150(20)30380-4
doi: 10.1016/j.atherosclerosis.2020.07.013
pii:
doi:

Substances chimiques

Arachidonic Acid 27YG812J1I
Eicosapentaenoic Acid AAN7QOV9EA

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

27-32

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Kazuo Fukumoto (K)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.

Yasuhiko Takemoto (Y)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: yatakemoto@med.osaka-cu.ac.jp.

Junichi Yoshikawa (J)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.

Naoki Norioka (N)

Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Tomokazu Iguchi (T)

Department of Cardiovascular Medicine, Bell Land General Hospital, Osaka, Japan.

Hiroki Namikawa (H)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.

Yoshihiro Tochino (Y)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.

Minoru Yoshiyama (M)

Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Taichi Shuto (T)

Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.

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