Plasma‐free eicosapentaenoic acid/arachidonic acid ratio: A possible new coronary risk factor

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Abstract
Seventy‐six effort angina patients who had typical angina on exertion documented by treadmill stress test with evidence of ischemic ST‐segment depression and 78 healthy volunteers in urban Japan were investigated in this study. Plasma free fatty acids (FFA) in both groups were determined using highperformance liquid chromatography. The relationships between the total cholesterol, high‐density lipoprotein (HDL), triglycerides in plasma, and the genesis of coronary heart disease were also examined. The ratio (0.08±0.08) of eicosapentaenoic acid (EPA)/arachidonic acid (AA) in plasma FFA was significantly lower in effort angina patients than that (0.15±0.12) in healthy volunteers. The lower ratio was due to significantly lower levels of EPA in the patients than in normals. in 42% of angina patients, the ratio is below 0.03. in all age subgroups except the age 30‐39 subgroup, the ratio of EPA/AA was significantly lower in patients than in normals, when divided into four subgroups by using a 10‐year age interval. Though the total cholesterol and triglycerides were not significantly different between the two groups, HDL was significantly lower and total cholesterol/HDL ratio was significantly higher in effort angina patients than in healthy volunteers. However, there was no correlation between EPA/AA ratio and HDL in individuals in either group. From these results, it could be concluded that lower EPA/AA ratio is a new coronary risk indicator other than HDL.