Association between low EPA levels and heart disease

Fish Oils and Cardiovascular Disease

AALBORG, DENMARK. There is increasing evidence that lipoprotein-associated phospholipase A2 (LPA2) is an independent risk factor for cardiovascular disease (heart disease). About 80% of LPA2 is bound to low-density cholesterol (LDL), 15-20% is bound to high-density cholesterol (HDL), and the remainder can be found in very low-density cholesterol (VLDL). A group of Danish and German researchers conducted a study to determine if the level of LPA2 in blood plasma correlates with the severity of coronary artery disease (CAD), which is one of the most common types of heart disease, and if there is any correlation between LPA2 level and the concentration of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fat (adipose) tissue.

Anti-inflammatory Effects of Fish Oil and Heart Disease

The study included 291 patients who had been referred for elective coronary angiography because of suspected CAD. The researchers observed a significant correlation between LPA2 concentration and severity of CAD with patients with 3-vessel disease (50% or greater narrowing [stenosis] of 3 major coronary arteries) having the highest LPA2 level. They also found that a high LPA2 level was significantly associated with a low level of EPA. The researchers speculate that the mechanism(s) by which fish oils (EPA and DHA) protect against CAD may include an interaction with LPA2. More specifically, fish oils may reduce the concentration of small dense LDL particles, which are the primary carriers of LPA2. Fish oils also have proven anti-inflammatory effects which, through an inhibitory effect of monocyte and macrophage reactivity, may reduce circulating levels of LPA2.
Schmidt, EB, et al. Lipoprotein-associated phospholipase A2 concentrations in plasma are associated with the extent of coronary artery disease and correlate to adipose tissue levels of marine n-3 fatty acids. Atherosclerosis, Vol. 196, 2008, pp. 420-24

Information for physicians: Multiple cardiology CME courses that discuss dyslipidemia are available through

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