Document Detail


Red blood cell fatty acid levels improve GRACE score prediction of 2-yr mortality in patients with myocardial infarction.
MedLine Citation:
PMID:  23044429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Blood omega-3 and omega-6 fatty acid levels have been associated with reduced risk for total mortality in patients with stable coronary heart disease (CHD), but their relationships with mortality in the setting of myocardial infarction (MI) are unknown.
OBJECTIVE: To determine the association between red blood cell (RBC) fatty acid levels measured at admission and 2-year mortality in MI patients, independent of the GRACE risk score, a traditional mode of risk stratification.
DESIGN: Admission RBC fatty acid levels were measured in patients enrolled in a prospective, 24-center MI registry (TRIUMPH). Two-year mortality was modeled with Cox proportional hazards regression to assess the extent to which the inclusion of fatty acid levels would improve, over and above the GRACE score, risk stratification for 2-year mortality.
RESULTS: RBC fatty acid data were available from 1144 patients who did not report taking fish oil supplements after discharge. Two RBC fatty acids [eicosapentaenoic acid (EPA) and docosapentaenoic n-6 (DPA)] were univariate predictors of total mortality. The combined fatty acid c-statistic (0.60, p<0.001) improved the c-statistic of the GRACE score alone from 0.747 (p<0.001) to 0.768 (p<0.05 vs. GRACE alone). The net reclassification index improved by 31% (95% CI, 15% to 48%) and the relative incremental discrimination index improved by 19.8% (7.5% to 35.7%).
CONCLUSION: RBC EPA and DPA n-6 levels improved the prediction of 2-yr mortality over and above the GRACE score in MI patients.
Authors:
William S Harris; Kevin F Kennedy; James H O'Keefe; John A Spertus
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Publication Detail:
Type:  Journal Article; Multicenter Study; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-06
Journal Detail:
Title:  International journal of cardiology     Volume:  168     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-09     Completed Date:  2014-05-06     Revised Date:  2014-10-14    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Erythrocytes / metabolism*
Fatty Acids, Omega-3 / blood*
Female
Humans
Male
Middle Aged
Mortality / trends
Myocardial Infarction / blood*,  diagnosis,  mortality*
Predictive Value of Tests
Prospective Studies
Registries
Risk Factors
Grant Support
ID/Acronym/Agency:
P50 HL077113/HL/NHLBI NIH HHS; P50 HL077113/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Fatty Acids, Omega-3
Comments/Corrections

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