Low eicosapentaenoic acid to arachidonic acid ratio is associated with thin-cap fibroatheroma determined by optical coherence tomography

BackgroundA low eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio is known to be associated with cardiovascular events. However, the relationship between the EPA/AA ratio and coronary plaque vulnerability assessed by optical coherence tomography (OCT) has not been examined thoroughly. This study examined the relationship between the EPA/AA ratio and coronary plaque vulnerability assessed by OCT in patients with acute coronary syndrome (ACS).MethodsWe evaluated 59 ACS patients who had undergone percutaneous coronary intervention using OCT. We divided them into 2 groups according to OCT findings—those with and without thin-cap fibroatheroma (TCFA)—and compared the EPA/AA ratio between the groups.ResultsWe identified 32 and 27 patients with and without TCFA, respectively. The EPA/AA ratio was significantly lower in patients with TCFA than in those without TCFA [0.35, interquartile range (0.21–0.44) vs. 0.54, interquartile range (0.42–0.70); p < 0.001]. In multivariate logistic regression analysis, the EPA/AA ratio was an independent predictor of TCFA (odds ratio, 0.09; 95% confidence interval, 0.007–0.99; p = 0.049). The EPA/AA ratio and fibrous cap thickness showed a significant positive correlation (Spearman ρ = 0.46; p < 0.001). Furthermore, receiver operating characteristic curve analysis showed that an EPA/AA ratio < 0.46 could predict TCFA (81.3%, sensitivity; 74.1%, specificity).ConclusionsA low serum EPA/AA ratio is significantly associated with coronary plaque vulnerability assessed by OCT in ACS patients.