N-3 polyunsaturated fatty acids early supplementation improves ultrasound indices of endothelial function, but not through NO inhibitors in patients with acute myocardial infarction N-3 PUFA supplementation in acute myocardial infarction

Background & aims: our aim was to evaluate early initiated one month n-3 polyunsaturated fatty acids (PUFA) supplementation effects on ultrasound indices of endothelial function and serum asymmetric dimethylarginine (ADMA) levels in patients with acute myocardial infarction (AMI). Methods: Forty patients with AMI and successful percutaneous coronary intervention (PCI) were recruited into the study and randomized to the study group (group P; n = 20; standard therapy + n-3 PUFA 1g daily) or the control group (group C; n = 20; standard therapy). Ultrasound indices of endothelial function: flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NMD) and serum ADMA concentrations (ELISA) were obtained before and after one month (30 +/- 1 days) therapy (presented as means standard +/- deviations). Results: There was a significant difference between both groups in mean delta (baseline/after one month) FMD (P: 8.1 +/- 12.6% vs C: -2.2 +/- 11.8%; p = 0.02) with no difference in mean delta NMD (P: 3.3 +/- 11.9% vs 0.66 +/- 14.3%; p = 0.53). We found also a significant increase in mean FMD (7.4 +/- 6.4 to 15.5 +/- 10.5%; p = 0.02) with a nonsignificant change in mean NMD values (26.9 +/- 12.1 to 30.2 +/- 14.0%; p = 0.24) after 1-month therapy with n-3 PUFA. FMD and NMD mean values did not change in control patients (FMD: 11.6 +/- 6.1% to 9.4 +/- 8.0%; p = 0.5 NMD: 25.1 +/- 11.4% to 25.8 +/- 14.0%; p = 0.84). The comparison of mean delta ADMA values for both groups revealed no differences (P: 6.2 +/- 9.7 mu mol/l vs C: 3.6 +/- 9.5 mu mol/l; p = 0.43). Mean serum ADMA concentrations were significantly increased after 1-month therapy in the group P (P: 2.1 +/- 1.8 to 8.3 +/- 9.7 mu mol/l; p = 0.001; C: 4.5 +/- 7.1 to 8.1 +/- 9.5 mu mol/l; p = 0.09). However, there was a nonsignificant difference in mean baseline serum ADMA levels between both groups (P: 2.1 +/- 1.8 mu mol/l vs C: 4.5 +/- 7.1 mu mol/l; p = 0.32). There were no significant correlations between FMD, NMD, ADMA levels and demographic, clinical or biochemical parameters. Conclusions: Early and short-term n-3 PUFA supplementation improved ultrasound indices of endothelial function without affecting serum ADMA levels in patients with AMI and successful primary PCI. (C) 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.