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Blood concentrations of individual long-chain n–3 fatty acids and risk of nonfatal myocardial infarction^1,2,3

¹ From the Departments of Nutrition (QS, HC, and FBH) and Epidemiology (DM and FBH), Harvard School of Public Health, Boston, MA, and the Channing Laboratory (JM, DM, and FBH), the Division of Cardiovascular Medicine (CMA and DM), and the Division of Preventive Medicine (KMR and CMA), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

Background: Whereas dietary intake of long-chain n–3 fatty acids has been associated with risk of nonfatal myocardial infarction (MI), few studies have examined the relation for blood concentrations.

Objective: We aimed to investigate the effect of long-chain n–3 fatty acids in blood on the risk of nonfatal MI.

Design: Baseline blood samples were collected from 32 826 participants of the Nurses' Health Study in 1989–1990, among whom 146 incident cases of nonfatal MI were ascertained during 6 y of follow-up and matched with 288 controls.

Results: After multivariate adjustment, the relative risks (95% CI) comparing the highest with the lowest quartiles in plasma were 0.23 (0.09, 0.55; P for trend = 0.001) for eicosapentaenoic acid (EPA), 0.40 (0.20, 0.82; P for trend = 0.004) for docosapentaenoic acid (DPA), and 0.46 (0.18, 1.16; P for trend = 0.07) for docosahexaenoic acid (DHA). The associations for these fatty acids in erythrocytes were generally weaker and nonsignificant. In contrast to EPA and DHA, blood concentrations of DPA were not correlated with dietary consumption of n–3 fatty acids. Higher plasma concentrations of EPA, DPA, and DHA were associated with higher plasma concentrations of HDL cholesterol and lower concentrations of triacylglycerol and inflammatory markers.

Conclusions: Higher plasma concentrations of EPA and DPA are associated with a lower risk of nonfatal MI among women. These findings may partly reflect dietary consumption but, particularly for DPA, may indicate important risk differences based on metabolism of long-chain n–3 fatty acids.

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