Abstract
Background Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches – by treatment randomisation and by stratification using measured n-3 PUFA. Methods Patients (n = 20) received 3 g/day of fish or placebo oil (FO vs PO) in a double blind randomised protocol prior to elective coronary artery graft and valve surgery. Groups were matched for age, gender, and mean treatment duration (∼20 days). Resected atrial myocardium was sampled for assay of viability metabolic markers, and blood obtained for erythrocyte membrane lipid measurement. Results There was substantial overlap of cell membrane n-3 PUFA content across PO and FO groups, and no group treatment effects on AF incidence or myocardial molecular marker levels were detected. In contrast, data stratification using membrane n-3 PUFA content (at 8% total membrane lipid) achieved significant separation of patients (by n-6:n-3 PUFA ratio), a significant differential cardiac expression of the marker peroxisomal proliferator-activated receptor, but no difference in AF incidence. Conclusions This small n-3 PUFA case study demonstrates that the same cohort may yield differing findings when evaluated using randomisation or stratification approaches based on direct molecular measures in cell membranes.
| Original language | English |
|---|---|
| Pages (from-to) | 846-855 |
| Number of pages | 10 |
| Journal | Heart Lung and Circulation |
| Volume | 26 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 1 Aug 2017 |
Keywords
- Atrial fibrillation
- Bax
- Bcl2
- Omega-3 polyunsaturated fatty acids (PUFA)
- Peroxisomal proliferator-activated receptor (PPAR)
Cite this
}
A Small Cohort Omega-3 PUFA Supplement Study : Implications of Stratifying According to Lipid Membrane Incorporation in Cardiac Surgical Patients. / Ip, Wendy T K; Chandramouli, Chanchal; Smith, Julian A.; McLennan, Peter Leslie; Pepe, Salvatore; Delbridge, Lea M Durham.
In: Heart Lung and Circulation, Vol. 26, No. 8, 01.08.2017, p. 846-855.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - A Small Cohort Omega-3 PUFA Supplement Study
T2 - Implications of Stratifying According to Lipid Membrane Incorporation in Cardiac Surgical Patients
AU - Ip, Wendy T K
AU - Chandramouli, Chanchal
AU - Smith, Julian A.
AU - McLennan, Peter Leslie
AU - Pepe, Salvatore
AU - Delbridge, Lea M Durham
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches – by treatment randomisation and by stratification using measured n-3 PUFA. Methods Patients (n = 20) received 3 g/day of fish or placebo oil (FO vs PO) in a double blind randomised protocol prior to elective coronary artery graft and valve surgery. Groups were matched for age, gender, and mean treatment duration (∼20 days). Resected atrial myocardium was sampled for assay of viability metabolic markers, and blood obtained for erythrocyte membrane lipid measurement. Results There was substantial overlap of cell membrane n-3 PUFA content across PO and FO groups, and no group treatment effects on AF incidence or myocardial molecular marker levels were detected. In contrast, data stratification using membrane n-3 PUFA content (at 8% total membrane lipid) achieved significant separation of patients (by n-6:n-3 PUFA ratio), a significant differential cardiac expression of the marker peroxisomal proliferator-activated receptor, but no difference in AF incidence. Conclusions This small n-3 PUFA case study demonstrates that the same cohort may yield differing findings when evaluated using randomisation or stratification approaches based on direct molecular measures in cell membranes.
AB - Background Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches – by treatment randomisation and by stratification using measured n-3 PUFA. Methods Patients (n = 20) received 3 g/day of fish or placebo oil (FO vs PO) in a double blind randomised protocol prior to elective coronary artery graft and valve surgery. Groups were matched for age, gender, and mean treatment duration (∼20 days). Resected atrial myocardium was sampled for assay of viability metabolic markers, and blood obtained for erythrocyte membrane lipid measurement. Results There was substantial overlap of cell membrane n-3 PUFA content across PO and FO groups, and no group treatment effects on AF incidence or myocardial molecular marker levels were detected. In contrast, data stratification using membrane n-3 PUFA content (at 8% total membrane lipid) achieved significant separation of patients (by n-6:n-3 PUFA ratio), a significant differential cardiac expression of the marker peroxisomal proliferator-activated receptor, but no difference in AF incidence. Conclusions This small n-3 PUFA case study demonstrates that the same cohort may yield differing findings when evaluated using randomisation or stratification approaches based on direct molecular measures in cell membranes.
KW - Atrial fibrillation
KW - Bax
KW - Bcl2
KW - Omega-3 polyunsaturated fatty acids (PUFA)
KW - Peroxisomal proliferator-activated receptor (PPAR)
UR - http://www.scopus.com/inward/record.url?scp=85013380430&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2016.12.007
DO - 10.1016/j.hlc.2016.12.007
M3 - Article
AN - SCOPUS:85013380430
VL - 26
SP - 846
EP - 855
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
SN - 1443-9506
IS - 8
ER -