The effect of supplementation with omega-3 fatty acids on soluble markers of endothelial function in patients with coronary heart disease

During progression of atherosclerosis the overlying endothelial cells alter their expression of some surface molecules. Circulating levels of such mol ecules may be quantified. We investigated the effect of omega-3 fatty acids (n-3 FA) on the levels of tissue plasminogen activator antigen, von Willeb rand factor, and the soluble forms of thrombomodulin, P-selectin, E-selecti n, and vascular cell adhesion molecule-1 in 54 patients with coronary heart disease. Twenty-three of the patients had taken 5.1 g/d n-3 FA for 6 month s (group I) and 31 were given corn oil as placebo (group II). For another 4 weeks ("the study period") they all got 5.1 g/d of n-3 FA. Compliance was confirmed by demonstration of changes in relevant fatty acids in serum phos pholipids. At baseline, significant differences between the groups were fou nd with lower median values of von Willebrand factor (128% versus 147%) and soluble thrombomodulin (24.9 versus 32.5 ng/mL) and higher median values o f soluble E-selectin (41.4 versus 35.5 ng/mL) and soluble vascular cell adh esion molecule-1 (573 versus 473 ng/mL) in group I. During the study period differences in changes between the groups were found; tissue plasminogen a ctivator antigen and soluble thrombomodulin decreased (P for difference bet ween the groups 0.001 and 0.015, respectively), whereas soluble E-selectin and soluble vascular cell adhesion molecule-1 increased (P for difference b etween the groups <0.01 for both) in group II relative to group I. Our resu lts indicate that n-3 FA supplementation decreases hemostatic markers of at herosclerosis, whereas markers of inflammation may be increased. The latter may be the result of lipid peroxidation as a simultaneous decrease of vita min E and increase in thiobarbituric acid-reactive substances were observed .