Omega-3 fatty acids in atherosclerosis and coronary artery disease

Abstract

Omega-3 polyunsaturated fatty acids have emerged as possible protective factors associated with a decreased risk for myocardial infarction in populations with a high marine food intake, which may relate to effects on lipid metabolism, thrombosis and inflammation. Omega-3 fatty acids decrease triglyceride levels and also compete as substrates for enzymes involved in the biosynthesis of lipid mediators. The balance between omega-3-derived specialized proresolving mediators and pro-inflammatory lipid mediators from arachidonic acid metabolism can be measured as the resolvin-to-leukotriene ratio, which has been shown to predict subclinical atherosclerosis. The results of experimental, observational and randomized studies of omega-3 fatty acids are somewhat variable and should be interpreted in view of the models used and the populations studied.

Lay abstract

Almost 40 years after the discovery of protective effects of fish oils on the heart and vessels, the mechanisms of action of omega-3 fatty acids remain unclear. In addition to effects on blood lipid levels, omega-3 fatty acids can be metabolized into bioactive lipid mediators. It has been proposed that such omega-3-derived bioactive lipids counteract the inflammation and blood clotting induced by lipid mediators from omega-6 fatty acids and that this contributes to the beneficial effects of fish oils.