Effects of polyunsaturated fatty acids on periprocedural myocardial infarction after elective percutaneous coronary intervention

Aims: The aim of this study was to address the association of lipid profiles with periprocedural myocardial infarction (pMI) after elective percutaneous coronary intervention (PCI). Methods and results: Of the 302 consecutive patients who received elective PCI at the Chubu Rosai Hospital, Nagoya, Japan between June 2009 and December 2010, data from 231 native coronary lesions were analysed. Various biomarkers including serum troponin T (TnT), eicosapentaenoic acid (EPA), arachidonic acid (AA), and low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were measured at baseline and at 18 hrs after PCI. pMI was defined as a post-procedural increase of TnT >3 times above the upper normal limit. Patients with pMI had significantly lower EPA/AA (0.25 [0.19-0.28] vs. 0.45 [0.21-0.62], p<0.001) and higher LDL/HDL cholesterol (3.00 +/- 1.05 vs. 2.36 +/- 0.90, p=0.008) than patients without pMI. On multivariate logistic analysis, EPA/AA per 0.1 increase (hazard ratio [HR] 0.62, 95% CI: 0.43-0.88, p=0.007), LDL/HDL (HR 1.92, 95% CI: 1.15-3.19, p=0.012), stented length (HR 1.40, 95% CI: 1.07-1.83, p=0.015), and the presence of unstable angina pectoris (UAP) (HR 8.89, 95% CI: 2.83-27.9, p<0.001) were significantly and independently associated with the incidence of pMI. Conclusions: EPA/AA and LDL/HDL were significantly associated with pMI after PCI, creating the possibility of a new therapeutic target of pMI.