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Reduced Thrombin Formation and Altered Fibrin Clot Properties Induced by Polyunsaturated Omega-3 Fatty Acids on Top of Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention (OMEGA-PCI Clot)

2011; Lippincott Williams & Wilkins; Volume: 31; Issue: 7 Linguagem: Inglês

10.1161/atvbaha.111.228593

1524-4636

Grzegorz Gajos, J Zalewski, Paweł Rostoff, Jadwiga Nessler, W Piwowarska, Anetta Undas,

Coronary Interventions and Diagnostics

Objective— The goal of this study was to investigate whether omega-3 polyunsaturated fatty acids (n-3 PUFA) are able to alter plasma fibrin clot properties and reduce thrombin formation in stable coronary artery disease patients undergoing percutaneous coronary intervention (PCI). Methods and Results— In an investigator-initiated, prospective, double-blind, placebo-controlled, randomized study, patients undergoing PCI who received standard pharmacotherapy were assigned to the treatment with 1 g/day n-3 PUFA (n=30) or placebo (n=24) for 1 month. Plasma fibrin clot permeability ( K s ); lysis time ( t 50% ); prothrombin fragment 1.2; and peak thrombin generation from automated thrombogram, 8-isoprostaglandin F 2α (8-iso-PGF 2α , an oxidative stress marker), and C-reactive protein were determined at baseline, 3 to 5 days after randomization, and 30 days after randomization. At baseline, both treatment groups did not differ significantly. A 1-month treatment with n-3 PUFA compared with placebo was associated with 15.3% higher K s , indicating larger pores in the fibrin network ( P =0.0005); 14.3% shorter t 50% , indicating increased susceptibility to fibrinolysis ( P <0.0001); 33.8% lower prothrombin fragment 1.2 ( P =0.0013); 13.4% lower peak thrombin generation ( P =0.04); and 13.1% lower 8-iso-PGF 2α ( P =0.009). Treatment with n-3 PUFA had no effect on fibrinogen and C-reactive protein. After 1 month of treatment, fibrinogen ( r =−0.53, P <0.0001), treatment assignment ( r =0.29, P =0.006) and 8-iso-PGF 2α ( r =−0.27, P =0.015) were independently associated with clot permeability ( P <0.0001, R 2 =0.66). Conclusion— Adding n-3 PUFA to standard therapy in stable patients undergoing PCI significantly decreases thrombin formation and oxidative stress and favorably alters fibrin clot properties. These findings indicate novel antithrombotic effects induced by n-3 PUFA in humans.