The clinical role and importance of essential fatty acids and lipid mediators in acute coronary syndromes

Introduction-Aim: Acute coronary syndrome (ACS) is an emergency that is usually caused by the instability of atherosclerotic plaque in the floor of atherosclerotic coronary artery disease. ACS which has a risk of cardiac death or myocardial infarction (MI) is characterized bye total-subtotal occlusion and resolution in the coronary arteries. Atherosclerosis which is the underlying cause of cardiovascular disease is an inflammatory disease of vascular wall. Nowadays, new lipid mediators (lipoxins, resolvins, protectins, etc.) that provide effective local resolution of the inflammation have been identified. These mediators provide tissue hemostasis by preventing excessive inflammation. Omega-3 fatty acids from the essential fatty acids have shown anti-inflammatory properties by providing the synthesis of lipid mediators and eicosanoids with less inflammatory properties. The role of oxidative stress is extremely important in progression of atherosclerosis. The degree of inflammatory response developed due to changes in the balance of serum lipids and essential fatty acids provides a basis for ACS by directing the pathogenesis of ACS. This study was planned to evaluate whether serum / plasma levels of fatty acids, lipid mediators and lipids were associated with prognosis, severity and clinical picture of ACS. Method-Results: The study included 81 patients with MI, 20 patients with unstable angina pectoris (USAP) and a group consisting of 31 people. Triglyceride levels were significantly higher in MI and USAP patients compared the control group (p=0,00025 and p=0,0015). When the fatty acid groups were evaluated as a ratio of albumin; MUFA/albumin and SFA/albümin ratios were significantly higher in MI group compared to control group (p<0,0001 and p=0,003). Oxidative stress parameters were also significantly higher in MI compared to control group. Although CD59 and lipoxin A4 levels were higher in control group, there was no significant differences between the groups (p>0,05). Conclusion: Serum triglyceride levels, MUFA/albumin and SFA/albumin ratio were found to be higher in ACS and these elevations were shown to be associated with oxidative stress and inflammation parameters. It was also seen that the lipid mediators that provide the resolution of inflammation have not changed enough to create a significant difference between the groups.