This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Amin, A. A. Articles by Spertus, J. A. Search for Related Content PubMed PubMed Citation Articles by Amin, A. A. Articles by Spertus, J. A. Related Collections Depression Coronary Artery Disease

Acute Coronary Syndrome Patients With Depression Have Low Blood Cell Membrane Omega-3 Fatty Acid Levels

From the Department of Cardiology (A.A.A., K.J.R., J.A.S.), Mid America Heart Institute, Saint Luke’s Hospital, Kansas City, Missouri and University of Missouri-Kansas City, Kansas City, Missouri; Department of Medicine (R.A.M.), University of New Mexico, Albuquerque, New Mexico; and the Department of Nutrition and Metabolic Disease (W.S.H.), University of South Dakota-Sioux Falls, South Dakota.

Address correspondence and reprint requests to Alpesh Amin, 4401 Wornall Road, Kansas City, MO 64111. E-mail: aamin{at}saint-lukes.org

Objective: To determine the extent to which levels of membrane eicosapentaenoic (EPA)+docosahexaenoic acids (DHA) (the omega-3 index) were associated with depression in patients with acute coronary syndrome (ACS). Depression is associated with worse cardiovascular (CV) outcomes in patients with ACS. Reduced levels of blood cell membrane omega-3 (n-3) fatty acids (FAs), an emerging risk factor for both CV disease and depression, may help to explain the link between depression and adverse CV outcomes.

Methods: We measured membrane FA composition in 759 patients with confirmed ACS. The analysis included not only EPA and DHA but also the n-6 FAs linoleic and arachidonic acids (LA and AA). Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ). Multivariable linear regression was used to adjust for demographic and clinical characteristics.

Results: There was a significant inverse relationship between the n-3 index and depressive symptoms (PHQ) in the fully adjusted model (p = .034). For every 4.54% point rise in the n-3 index, there was a 1-point decline in depressive symptoms. In contrast to the n-3 FAs, membrane levels of the n-6 FAs LA and AA were not different between depressed and nondepressed ACS patients.

Conclusion: We found an inverse relationship between the n-3 index and the prevalence of depressive symptoms in patients with ACS. Therefore, this study supports the hypothesis that reduced n-3 FA tissue levels are a common and potentially modifiable link between depression and adverse CV outcomes.

Key Words: depression • acute coronary syndrome • omega-3 fatty acids

Abbreviations: AA = arachidonic acid; ACS = acute coronary syndrome; BMI = body mass index; CAD = coronary artery disease; CV = cardiovascular; DHA = docosahexaenoic acid; EPA = eicosapentanenoic acid; FA = fatty acids; GC = gas chromatography; MI = myocardial infarction; n-3 = omega-3; n-6 = omega-6; PHQ = Patient Health Questionnaire-9; UA = unstable angina.

This article has been cited by other articles:

				R. M. Carney, K. E. Freedland, E. H. Rubin, M. W. Rich, B. C. Steinmeyer, and W. S. Harris Omega-3 Augmentation of Sertraline in Treatment of Depression in Patients With Coronary Heart Disease: A Randomized Controlled Trial JAMA, October 21, 2009; 302(15): 1651 - 1657. [Abstract] [Full Text] [PDF]