期刊
JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS
卷 21, 期 7, 页码 712-729出版社
JAPAN ATHEROSCLEROSIS SOC
DOI: 10.5551/jat.21022
关键词
Eicosapentaenoic acid; Cytokine; Heart failure; Dyslipidemia
Aims: The effects of eicosapentaenoic acid (EPA) on the levels of inflammatory markers, cardiac function and long-term prognosis in chronic heart failure (CHF) patients with dyslipidemia remain unclear. Methods: A total of 139 CHF patients with a mean left ventricular ejection fraction (LVEF) of 37.6 +/- 8.0% were divided into two groups based on whether EPA was included in their treatment regimen: the EPA group (n = 71) and the no EPA group (n = 68). Only patients with dyslipidemia at baseline (entry) were treated with EPA. The monocyte chemoattractant protein (MCP)-1 and asymmetric dimethylarginine (ADMA) levels were measured at baseline and after 12 months of treatment. Results: At 12 months, in the EPA group, the LVEF had improved and the MCP-1 and ADMA levels had decreased (respectively, p<0.001); however, in the no EPA group, the LVEF had worsened, while the MCP-1 and ADMA levels had increased (respectively, p<0.001). Fifty-five patients experienced cardiac events, including 15 cardiac deaths and 40 readmissions for worsening of CHF during a median follow-up period of 28.0 months. The percent change in LVEF from baseline was found to be significantly associated with the percent change in ADMA (r = -0.462, p<0.001). A multivariate Cox hazard analysis showed EPA treatment (hazard ratio: 0.21, 95% confidence interval: 0.05-0.93, p=0.031) to be an independent predictor of cardiac events. Conclusions: These data indicate that EPA treatment may improve the cardiac function and long-term prognosis of CHF patients with dyslipidemia, at least in part, due to reductions in inflammation and improvements in the endothelial function.
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