Aspirin and omega-3 fatty acid status interact in the prevention of cardiovascular diseases in Framingham Heart Study.
Aspirin
Cardiovascular disease
Docosahexaenoic acid
Eicosapentaenoic acid
Fatty acid
Journal
Prostaglandins, leukotrienes, and essential fatty acids
ISSN: 1532-2823
Titre abrégé: Prostaglandins Leukot Essent Fatty Acids
Pays: Scotland
ID NLM: 8802730
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
14
12
2020
revised:
18
03
2021
accepted:
12
04
2021
pubmed:
9
5
2021
medline:
1
2
2022
entrez:
8
5
2021
Statut:
ppublish
Résumé
The roles of omega-3 (n3) fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] and low-dose aspirin in the primary prevention of ischemic cardiovascular disease (CVD) are controversial. Since omega-3 (n3) fatty acids and aspirin affect cyclooxygenase activity in platelets, there could be a clinically-relevant effect of aspirin combined with a particular n3 fatty acid level present in each individual. RBC EPA+DHA, arachidonic acid (AA) and docosapentaenoic acid (DPA) were measured in 2500 participants without known CVD in the Framingham Heart Study. We then tested for interactions with reported aspirin use (1004 reported use and 1494 did not) on CVD outcomes. The median follow-up was 7.2 years. Having RBC EPA+DHA in the second quintile (4.2-4.9% of total fatty acids) was associated with significantly reduced risk for future CVD events (relative to the first quintile, <4.2%) in those who did not take aspirin (HR 0.54 (0.30, 0.98)), but in those reporting aspirin use, risk was significantly increased (HR 2.16 (1.19, 3.92)) in this quintile. This interaction remained significant when adjusting for confounders. Significant interactions were also present for coronary heart disease and stroke outcomes using the same quintiles. Similar findings were present for EPA and DHA alone but not for DPA and AA. There is a complex interaction between aspirin use and RBC EPA+DHA levels on CVD outcomes. This suggests that aspirin use may be beneficial in one omega-3 environment but harmful in another, implying that a personalized approach to both aspirin use and omega-3 supplementation may be needed.
Sections du résumé
BACKGROUND
The roles of omega-3 (n3) fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] and low-dose aspirin in the primary prevention of ischemic cardiovascular disease (CVD) are controversial. Since omega-3 (n3) fatty acids and aspirin affect cyclooxygenase activity in platelets, there could be a clinically-relevant effect of aspirin combined with a particular n3 fatty acid level present in each individual.
METHODS
RBC EPA+DHA, arachidonic acid (AA) and docosapentaenoic acid (DPA) were measured in 2500 participants without known CVD in the Framingham Heart Study. We then tested for interactions with reported aspirin use (1004 reported use and 1494 did not) on CVD outcomes. The median follow-up was 7.2 years.
RESULTS
Having RBC EPA+DHA in the second quintile (4.2-4.9% of total fatty acids) was associated with significantly reduced risk for future CVD events (relative to the first quintile, <4.2%) in those who did not take aspirin (HR 0.54 (0.30, 0.98)), but in those reporting aspirin use, risk was significantly increased (HR 2.16 (1.19, 3.92)) in this quintile. This interaction remained significant when adjusting for confounders. Significant interactions were also present for coronary heart disease and stroke outcomes using the same quintiles. Similar findings were present for EPA and DHA alone but not for DPA and AA.
CONCLUSIONS
There is a complex interaction between aspirin use and RBC EPA+DHA levels on CVD outcomes. This suggests that aspirin use may be beneficial in one omega-3 environment but harmful in another, implying that a personalized approach to both aspirin use and omega-3 supplementation may be needed.
Identifiants
pubmed: 33964664
pii: S0952-3278(21)00046-6
doi: 10.1016/j.plefa.2021.102283
pmc: PMC8159885
mid: NIHMS1701183
pii:
doi:
Substances chimiques
Fatty Acids, Unsaturated
0
Docosahexaenoic Acids
25167-62-8
Arachidonic Acid
27YG812J1I
Eicosapentaenoic Acid
AAN7QOV9EA
docosapentaenoic acid
NS3OZT14QT
Aspirin
R16CO5Y76E
Banques de données
ClinicalTrials.gov
['NCT00005121']
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
102283Subventions
Organisme : NHLBI NIH HHS
ID : HHSN268201500001C
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201500001I
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01HC25195
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL089590
Pays : United States
Informations de copyright
Copyright © 2021. Published by Elsevier Ltd.
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