A lower eicosapentaenoic acid/arachidonic acid ratio is associated with in-hospital fatal arrhythmic events in patients with acute myocardial infarction: a J-MINUET substudy

作者：Hashimoto Takuya; Ako Junya; Nakao Koichi; Ozaki Yukio; Kimura Kazuo; Noguchi Teruo; Yasuda Satoshi; Suwa Satoru; Fujimoto Kazuteru; Nakama Yasuharu; Morita Takashi; Shimizu Wataru; Saito Yoshihiko; Hirohata Atsushi; Morita Yasuhiro; Inoue Teruo; Okamura Atsunori; Uematsu Masaaki; Hirata Kazuhito; Tanabe Kengo; Shibata Yoshisato; Owa Mafumi; Tsujita Kenichi; Funayama Hiroshi; Kokubu Nobuaki; Kozuma Ken; Uemura Shirou; Toubaru Tetsuya; Saku Keijirou; Ohshima Shigeru

来源：Heart and Vessels, 2018, 33(5): 481-488.

DOI：10.1007/s00380-017-1084-2

• Eicosapentaenoic acid/arachidonic acid ratio
• Percutaneous coronary intervention
• Acute myocardial infarction
• Fatal arrhythmic events

The ratio of serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) is significantly associated with long-term clinical outcomes in patients with acute myocardial infarction (AMI). However, it has not been conclusively demonstrated that higher serum EPA/AA ratio fares better clinical outcomes in the early phase of AMI. The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry conducted in 28 Japanese medical institutions between July 2012 and March 2014. We enrolled 3,283 consecutive AMI patients who were admitted to participating institutions within 48 h of symptom onset. A serum EPA/AA ratio was available for 629 of these patients. The endpoints were in-hospital mortality and major adverse cardiac events (MACE), defined as a composite of all cause death, cardiac failure, ventricular tachycardia (VT) and/or ventricular fibrillation (VF) and bleeding during hospitalization. Although similar rates of in-hospital mortality, cardiac failure, bleeding, and MACE were found in the lower serum EPA/AA group and higher serum EPA/AA group, the incidence of VT/VF during hospitalization was significantly higher in the low ratio group (p = 0.008). Receiver operating characteristic curve analysis showed that an EPA/AA ratio < 0.35 could predict the incidence of VT/VF with 100% sensitivity and 64.0% specificity. A lower serum EPA/AA ratio was associated with a higher frequency of fatal arrhythmic events in the early phase of AMI.

• 出版日期2018-5