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. 2017 Feb:60:136-141.
doi: 10.1016/j.bbi.2016.10.005. Epub 2016 Oct 11.

Oxidative stress predicts depressive symptom changes with omega-3 fatty acid treatment in coronary artery disease patients

Graham Mazereeuw  1 , Nathan Herrmann  2 , Ana C Andreazza  3 , Gustavo Scola  4 , David W L Ma  5 , Paul I Oh  6 , Krista L Lanctôt  7
Affiliations
Free article

Oxidative stress predicts depressive symptom changes with omega-3 fatty acid treatment in coronary artery disease patients

Graham Mazereeuw et al. Brain Behav Immun. 2017 Feb.
Free article

Abstract

Background: Antidepressant efficacy of omega-3 polyunsaturated fatty acid (n-3 PUFA) treatment in coronary artery disease (CAD) patients remains unpredictable. N-3 PUFA can mitigate oxidative stress, which is common in CAD and may contribute to depressive symptoms. This study investigated whether greater pre-treatment oxidative stress, measured by the ratios of late-stage lipid peroxidation markers (malondialdehyde [MDA], 4-hydroxy-2-nonenal [4-HNE], and 8-isoprostane [8-ISO]) to an early-stage marker (lipid hydroperoxides [LPH]), predicted n-3 PUFA antidepressant benefits in CAD.

Methods: This was a secondary analysis of CAROTID (CAD Randomized Omega-3 Trial in Depression, NCT00981383). Patient demographics and medical characteristics were collected. Depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale (HAM-D). Patients were then randomized to receive either 1.9g/day n-3 PUFA or placebo for 12weeks, after which HAM-D scores were reassessed. Baseline LPH, 4-HNE, 8-ISO, MDA and n-3 PUFA concentrations were analysed from fasting blood.

Results: Seventy-nine patients (age=61.1±8.5, 76% male, HAM-D=7.5±6.1) were included (n=45 placebo, n=34 n-3 PUFA). In the n-3 PUFA group, higher baseline ratios of MDA/LPH (primary analysis: F1,33=6.20, beta=-0.35, p=0.018), 4-HNE/LPH (exploratory analysis: F1,33=5.35, beta=-0.32, p=0.027), and 8-ISO/LPH (exploratory analysis: F1,33=6.10, beta=-0.33, p=0.019), indicating higher oxidative stress, were associated with greater depressive symptom improvement. In each model, higher baseline EPA+DHA concentrations independently predicted depressive symptom improvement with n-3 PUFA (MDA/LPH: F1,33=11.05, p=0.002; 4-HNE/LPH: F1,33=11.36, p=0.002; 8-ISO/LPH: F1,33=13.15, p=0.001). No associations were observed in the placebo group.

Conclusions: n-3 PUFA may be more likely to improve depressive symptoms in CAD patients with pre-treatment evidence of oxidative stress.

Keywords: Cardiovascular; Coronary artery disease; DHA; Depression; Docosahexaenoic acid; EPA; Eicosapentaenoic acid; Fish oil; Heart disease; Hydroperoxide; Hydroxynonenal; Isoprostane; Lipid peroxidation; Malondialdehyde; Mood; Omega-3 fatty acid; Oxidative stress.

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