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Title: | A Small Cohort Omega-3 PUFA Supplement Study: Implications of Stratifying According to Lipid Membrane Incorporation in Cardiac Surgical Patients. | Authors: | Delbridge L.M.D.;Ip W.T.K.;Chandramouli C.;Smith J.A. ;McLennan P.L.;Pepe S. | Monash Health Department(s): | Cardiothoracic Surgery | Institution: | (Ip, Chandramouli, Delbridge) Cardiac Phenomics Laboratory, Department of Physiology, University of Melbourne, Melbourne, Vic, Australia (Smith) Department of Cardiothoracic Surgery, Monash Health, Monash University, Melbourne, Vic, Australia (Smith) Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Vic, Australia (McLennan) Graduate School of Medicine, Centre for Human Applied Physiology, University of Wollongong, Sydney, NSW, Australia (Pepe) Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Vic, Australia | Issue Date: | 7-Jul-2017 | Copyright year: | 2017 | Publisher: | Elsevier Ltd | Place of publication: | United Kingdom | Publication information: | Heart Lung and Circulation. 26 (8) (pp 846-855), 2017. Date of Publication: August 2017. | Journal: | Heart Lung and Circulation | Abstract: | Background Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches - by treatment randomisation and by stratification using measured n-3 PUFA. Methods Patients (n = 20) received 3 g/day of fish or placebo oil (FO vs PO) in a double blind randomised protocol prior to elective coronary artery graft and valve surgery. Groups were matched for age, gender, and mean treatment duration (~20 days). Resected atrial myocardium was sampled for assay of viability metabolic markers, and blood obtained for erythrocyte membrane lipid measurement. Results There was substantial overlap of cell membrane n-3 PUFA content across PO and FO groups, and no group treatment effects on AF incidence or myocardial molecular marker levels were detected. In contrast, data stratification using membrane n-3 PUFA content (at 8% total membrane lipid) achieved significant separation of patients (by n-6:n-3 PUFA ratio), a significant differential cardiac expression of the marker peroxisomal proliferator-activated receptor, but no difference in AF incidence. Conclusions This small n-3 PUFA case study demonstrates that the same cohort may yield differing findings when evaluated using randomisation or stratification approaches based on direct molecular measures in cell membranes.Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.hlc.2016.12.007 | ORCID: | McLennan, Peter L.; ORCID: http://orcid.org/0000-0003-0252-8039 | Link to associated publication: | Click here for full text options | PubMed URL: | 28237535 [http://www.ncbi.nlm.nih.gov/pubmed/?term=28237535] | ISSN: | 1443-9506 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38667 | Type: | Article | Subjects: | lipid composition *lipid membrane male middle aged pilot study preoperative treatment priority journal protein blood level protein expression randomized controlled trial surgical patient lipid blood level *omega 3 fatty acid/ct [Clinical Trial] *omega 3 fatty acid/cm [Drug Comparison] *omega 3 fatty acid/pd [Pharmacology] atrial fibrillation article aged adult treatment duration *diet supplementation double blind procedure drug effect drug mechanism erythrocyte membrane female heart valve surgery human human tissue lipid analysis peroxisome proliferator activated receptor alpha/ec [Endogenous Compound] placebo protein Bax/ec [Endogenous Compound] protein bcl 2/ec [Endogenous Compound] protein kinase B/ec [Endogenous Compound] clinical article cohort analysis controlled study coronary artery bypass graft treatment duration adult aged Article atrial fibrillation clinical article cohort analysis controlled study coronary artery bypass graft *diet supplementation double blind procedure drug effect drug mechanism erythrocyte membrane female heart valve surgery human human tissue lipid analysis lipid blood level lipid composition *lipid membrane male middle aged pilot study preoperative treatment priority journal protein blood level protein expression randomized controlled trial surgical patient |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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