Abstract 2408: Relationship between Outcome and Polyunsaturated Fatty Acids level in Acute Ischemic Stroke
Introduction: Fish intake is greater in the Japanese than in the Europeans and Americans, and the Japanese have higher levels of n-3 polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) than the Europeans and Americans. Although n-3 PUFA have attracted much attention in stroke management, relationship between n-3 PUFA and subtypes of ischemic stroke remains largely uninvestigated. The primary objective of this study was to assess the difference of the serum PUFA level among the subtypes of ischemic stroke in acute phase. Key secondary objective included assessment of relationship between good outcome and some laboratory data included serum PUFA.
Methods: We retrospectively evaluated 697 consecutive patients with acute cerebral infarction who were hospitalized in our hospital. We excluded the patients who were not examined serum fatty acid fractions during their hospitalization. In this study, we selected 221 patients with lacunar infarction (LI; n = 85), atherothrombotic infarction (AT; n = 78) and cardiogenic embolism (CE; n = 58). On the day two or day three of hospitalization, all patients in this study were performed blood examinations with fasting state; low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglyceride (TG), blood glucose (BG), hemoglobin A1c by National Glycohemoglobin Standardization Program (HbA1c) and uric acid (UA). We also examined serum fatty acid fractions: icosapentaenoic acid (EPA), docosahexaenoic acid (DHA), dihomo-γ-linolenic acid (DGLA) and arachidonic acid (AA). We calculated EPA/AA, DHA/AA and DGLA/AA ratio. We used modified Rankin scale (mRS) to assess clinical outcome at discharge, and defined good outcome as mRS score ≤2.
Results: EPA/AA ratio was 0.460±0.263 in the LI group, was 0.425±0.251 in the AT group, and was 0.389±0.193 in the CE group (not significant, Kruskal-Wallis test). DHA/AA ratio was 0.981±0.317 in the LI group, was 0.910±0.261 in the AT group, and was 0.877±0.268 in the CE group (not significant, ANOVA). DGLA/AA ratio was significantly higher in the LI group (0.221±0.067) than in the AT group (0.197±0.060, p<0.05) and in the CE group (0.195±0.056, p<0.05, Tukey-Kramer post hoc test). The probability for good outcome and independence was positively affected by diagnosis of LI (OR, 95%CI; 2.32, 1.18 to 5.00) and higher EPA/AA ratio (2.92, 1.42 to 6.24, logistic regression analysis).
Conclusions: There was no significant difference in the serum EPA/AA ratio among the three stroke subgroups. Considering the confounding factors, high EPA/AA ratio was related with good outcome in the ischemic stroke. Our paper suggested that dietary habits before the attack might affect their outcome in the patients with ischemic stroke.
- © 2012 by American Heart Association, Inc.