Saturated fatty acids and mortality in patients referred for coronary angiography-The Ludwigshafen Risk and Cardiovascular Health study

Abstract

Background: Saturated fatty acids are thought to be harmful by increasing the risk for cardiovascular events.

Objective: We examined the associations of erythrocyte saturated fatty acids with total and cardiovascular mortality in patients referred for coronary angiography.

Methods: Red blood cell saturated fatty acid (RBC SFA) proportions were measured by gas chromatography at baseline in 3259 participants of the Ludwigshafen Risk and Cardiovascular Health study. Associations of saturated fatty acid concentrations with mortality were investigated using Cox proportional hazards regression.

Results: During a median follow-up of 9.9 years, 975 patients (29.9%) died and 614 patients (18.8%) died of cardiovascular causes. The proportion of palmitic acid (PA, C16:0) ranged from 15.1% to 27.4% with a mean (standard deviation) of 21.9% (1.15%) and was associated with an increased risk for mortality in models adjusted for conventional cardiovascular risk factors. An increase of 1-standard deviation in PA was associated with a hazard ratio (95% confidence interval) of 1.08 (1.01-1.16) for all cause and 1.05 (0.96-1.15) for cardiovascular mortality after adjustment for cardiovascular risk factors. For the other investigated RBC SFA (C14:0, C18:0, C20:0, C22:0, and C24:0), there was no association with mortality and also not for the sum of all saturated fatty acids.

Conclusions: Our results reveal association with increased mortality risk only for PA but not for the other RBC SFAs or the sum of all RBC SFAs and emphasize the need to investigate each fatty acid individually rather than studying groups of fatty acids.

Keywords: Coronary artery disease; Mortality; Palmitic acid; Saturated fatty acids; Stearic acid.