Effect of omega-3 fatty acid ethyl esters on postprandial arterial elasticity in patients with familial hypercholesterolemia

Background: Impaired arterial elasticity reflects increased risk of atherosclerotic cardiovascular disease in patients with familial hypercholesterolemia (FH). Treatment with omega-3 fatty acid ethyl esters (co- 3FAEEs) in FH patients has been shown to improve postprandial triglyceride-rich lipoprotein (TRL) metabolism, including TRL-apolipoprotein(a) [TRL-apo(a)]. Whether co-3FAEE intervention also improves postprandial arterial elasticity in FH has not been demonstrated.Methods: We carried out an 8-week open-label, randomized, crossover trial to test the effect of co-3FAEEs (4 g/day) on postprandial arterial elasticity in 20 FH subjects following ingestion of an oral fat load. Fasting and postprandial large (C1) and small (C2) artery elasticity at 4 and 6 h were measured by pulse contour analysis of the radial artery. The area under-the-curves (AUCs) (0-6 h) for C1, C2, plasma tri-glycerides and TRL-apo(a) were determined using the trapezium rule.Results: Compared with no treatment, co-3FAEEs significantly increased fasting (+9%, P < 0.05) and postprandial C1 at 4 h (+13%, P < 0.05) and at 6 h (+10%, P < 0.05), with improvement in the postprandial C1 AUC (+10%, P < 0.01). co-3FAEEs also decreased postprandial triglyceride and TRL-apo(a) AUCs (-17% and-19%, respectively, P < 0.05). co-3FAEEs had no significant effect on fasting and postprandial C2. The change in C1 AUC was inversely associated with the changes in the AUC of triglycerides (r =-0.609, P < 0.01) and TRL-apo(a) (r =-0.490, P < 0.05).Conclusions: High-dose co-3FAEEs improves postprandial large artery elasticity in adults with FH. Reduction in postprandial TRL-apo(a) with co-3FAEEs may contribute to the improvement in large artery elasticity. However, our findings need to be confirmed in a larger population. Clinical trial registration: https://www.clinicaltrials.com/NCT01577056.(c) 2023 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.