Cell Membrane Trans-Fatty Acids and the Risk of Primary Cardiac Arrest

Background—The relation of trans-fatty acid intake to life-threatening arrhythmias and primary cardiac arrest is unknown. Methods and Results—We investigated the association of trans-fatty acid intake, assessed through a biomarker, with the risk of primary cardiac arrest in a population-based case-control study. Cases, aged 25 to 74 years, were out-of-hospital cardiac arrest patients attended by paramedics in Seattle, Washington from 1988 to 1999 (n=179). Controls, matched to cases by age and sex, were randomly identified from the community (n=285). Participants were free of previous clinically diagnosed heart disease. Blood was obtained at the time of cardiac arrest (cases) or at the time of an interview (controls) to assess trans-fatty acid intake. Higher total trans-fatty acids in red blood cell membranes was associated with a modest increase in the risk of primary cardiac arrest after adjustment for medical and lifestyle risk factors (odds ratio for interquintile range, 1.5; 95% CI, 1.0 to 2.1). However, trans isomers of oleic acid were not associated with risk (odds ratio for interquintile range, 0.8; 95% CI, 0.5 to 1.2), whereas higher levels of trans isomers of linoleic acid were associated with 3-fold increase in risk (odds ratio for interquintile range, 3.1; 95% CI, 1.7 to 5.4). Conclusions—These findings suggest that dietary intake of total trans-fatty acids is associated with modest increase and trans isomers of linoleic acid with a larger increase in the risk of primary cardiac arrest. These associations need to be confirmed in future studies that distinguish between trans isomers of linoleic acid and trans isomers of oleic acid.

[1]  V. Rastogi,et al.  Randomized, Double-Blind, Placebo-Controlled Trial of Fish Oil and Mustard Oil in Patients with Suspected Acute Myocardial Infarction: The Indian Experiment of Infarct Survival—4 , 1997, Cardiovascular Drugs and Therapy.

[2]  E. Feskens,et al.  Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study , 2001, The Lancet.

[3]  R. Virmani,et al.  Sudden cardiac death. , 1987, Human pathology.

[4]  G. Billman,et al.  The Antiarrhythmic and Anticonvulsant Effects of Dietary N-3 Fatty Acids , 1999, The Journal of Membrane Biology.

[5]  GISSI-Prevenzione Investigators,et al.  Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial , 1999, The Lancet.

[6]  Roberto Marchioli,et al.  Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. , 1999 .

[7]  G. Billman,et al.  Prevention of Sudden Cardiac Death by Dietary Pure ω-3 Polyunsaturated Fatty Acids in Dogs , 1999 .

[8]  B. Psaty,et al.  Assessment of trans-fatty acid intake with a food frequency questionnaire and validation with adipose tissue levels of trans-fatty acids. , 1998, American journal of epidemiology.

[9]  A. Kafatos,et al.  Trans fatty acids in dietary fats and oils from 14 European countries : the TRANSFAIR study , 1998 .

[10]  A. Aro,et al.  Trans fatty acids in dairy and meat products from 14 European countries : the TRANSFAIR study , 1998 .

[11]  D. Albanes,et al.  The α-tocopherol, β-carotene cancer prevention study , 1997 .

[12]  W C Willett,et al.  Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. , 1997, American journal of epidemiology.

[13]  David S. Siscovick,et al.  A multiple-imputation analysis of a case-control study of the risk of primary cardiac arrest among pharmacologicallytreated hypertensives , 1996 .

[14]  T. Raghunathan,et al.  Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. , 1995, JAMA.

[15]  D. Wood,et al.  Trans isomers of oleic and linoleic acids in adipose tissue and sudden cardiac death , 1995, The Lancet.

[16]  Charnock Js.  Dietary fats and cardiac arrhythmia in primates. , 1994 .

[17]  J. Charnock.  Dietary fats and cardiac arrhythmia in primates. , 1994, Nutrition.

[18]  J. Manson,et al.  Intake of trans fatty acids and risk of coronary heart disease among women , 1993, The Lancet.

[19]  M. Abeywardena,et al.  Dietary lipid modulation of ventricular fibrillation threshold in the marmoset monkey. , 1992, American heart journal.

[20]  M. Katan.  Isomeric trans fatty acids in the US diet. , 1991 .

[21]  T. Dolecek,et al.  Dietary polyunsaturated fatty acids and mortality in the Multiple Risk Factor Intervention Trial (MRFIT). , 1991, World review of nutrition and dietetics.

[22]  J. Sampugna,et al.  Isomeric trans fatty acids in the U.S. diet. , 1990, Journal of the American College of Nutrition.

[23]  P. Elwood,et al.  EFFECTS OF CHANGES IN FAT, FISH, AND FIBRE INTAKES ON DEATH AND MYOCARDIAL REINFARCTION: DIET AND REINFARCTION TRIAL (DART) , 1989, The Lancet.

[24]  J. Sebedio,et al.  Linoleic acid isomers in heat treated sunflower oils , 1988 .

[25]  E A Emken,et al.  Nutrition and biochemistry of trans and positional fatty acid isomers in hydrogenated oils. , 1984, Annual review of nutrition.

[26]  J J Heger,et al.  Sudden cardiac death. , 1998, Circulation.

[27]  K. Michael Cummings,et al.  Random Digit Dialing: A Sampling Technique for Telephone Surveys , 1979 .