Role of polyunsaturated fatty acids in Japanese patients with coronary spastic angina

Background: n-3 polyunsaturated fatty acids (PUFAs) reduce the risk of ischemic heart disease. However, there are few reports of a relationship between n-3 PUFAs and coronary spastic angina (CSA). This study aimed to assess the age-dependent role of serum levels of fatty acid in patients with CSA.Methods and results: We enrolled 406 patients who underwent ergonovine tolerance test (ETT) during coronary angiography for evaluation of CSA. All ETT-positive subjects were diagnosed as having CSA. We categorized the patients by age and results of ETT as follows: (1) young (age <= 65 years) CSA-positive (n = 32), (2) young CSA-negative (n = 134), (3) elderly (age > 66 years) CSA-positive (n = 36), and (4) elderly CSA-negative (n = 204) groups. We evaluated the serum levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), ar-achidonic acid, and dihomo-gamma-linolenic acid. In the young groups, the serum levels of EPA (64.3 +/- 37.7 mu g/mL vs. 49.4 +/- 28.8 mu g/mL, p = 0.015) and DHA (135.7 +/- 47.6 mu g/mL vs. 117.4 +/- 37.6 mu g/mL, p = 0.020) were significantly higher in the CSA-positive group than in the CSA-negative group, respectively. However, this was not the case with elderly groups. In the multivariate analysis in young groups, the serum levels of EPA (p = 0.028) and DHA (p = 0.049) were independently associated with the presence of CSA, respectively.Conclusion: Our results suggested that the higher serum levels of EPA and/or DHA might be involved in the path-ophysiology of CSA in the young population but not in the elderly population.(c) 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.