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Submitted on January 27, 2006
Accepted on March 27, 2006
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria (S.P, H.S., B.T., W.M), LURIC Study non-profit LLC, Freiburg, Germany (U.S., B.W.), Division of Endocrinology and Diabetes, Graduate School Molecular Endocrinology and Diabetes, Ulm University, Germany (B.O.B.), Division of Cardiology, Center of Internal Medicine, Dr. Pohl Stiftungsprofessur Preventive Cardiology, University Hospital Marburg, Germany (J.R.S.)
* To whom correspondence should be addressed. E-mail: winfried.maerz{at}klinikum-graz.at.
Context: Free fatty acids (FFA) are associated with several cardiovascular risk factors and exert harmful effects on the myocardium.
Objective: The aim of our study was to elucidate the relationship between FFA and mortality in subjects who underwent coronary angiography.
Design, Setting, Participants: LURIC is a prospective cohort study of Caucasians who had undergone coronary angiography at baseline (1997-2000). During a median time of follow-up of 5.38 yr, 513 deaths had occurred among 3315 study participants with measured FFA.
Main Outcome Measure: Hazard ratios for mortality according to FFA levels.
Results: At the fourth quartile of FFA, fully adjusted hazard ratios for death from any cause and from cardiovascular causes were 1.58 (P = 0.002) and 1.83 (P = 0.001), respectively. In persons with angiographic coronary artery disease (CAD), stable CAD and unstable CAD, the predictive value of FFA was similar to that in the entire cohort, but the association did not attain statistical significance in persons without CAD analyzed separately. Free fatty acid levels were not related to the presence of angiographic CAD, but were elevated in subjects with unstable CAD compared with probands with stable CAD. Furthermore, FFA increased with the severity of heart failure and were positively correlated with N terminal pro-B-type natriuretic peptide (NT-pro-BNP) (P < 0.001).
Conclusions: Free fatty acid levels independently predict all-cause and cardiovascular mortality in subjects with angiographic CAD. A possible diagnostic use of FFA warrants further studies, but our results may underline the importance of therapeutic approaches to influence FFA metabolism.
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