PARAMETERS OF ARACHYDONIC ACID CYCLE METABOLISM IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION ON THE BACKGROUND OF COMPLEX THERAPY OF OMEGA-3 POLYUNSATURATED FATTY ACIDS

The aim of the study was to evaluate the effect of omega-3 polyunsaturated fatty acids on the main metabolic rates of the arachydonic acid cycle in patients with acute myocardial infarction in the context of traditional complex therapy. Materials and methods of research. We conducted an open, randomized study of two groups of patients (n=59) with acute myocardial infarction (MI), which did not undergo angioplastic and thrombolysis: in the main group (n=26) traditional complex therapy (including double antiaggregant therapy) from the first day supplemented with Omega-3 triglycerides [EPA/DGA — 1.2/1-90%] 1g. per day. In the control group (n=33) only complex therapy was performed. The main components of the arachydonic acid cycle — thromboxane B2 (TxB2) and prostaglandin I2 (PgI2), as well as their analogues, thromboxane B3 (TxB3) and prostaglandin I3 (PgI3), resulting from the replacement of arachidonic acid by omega-3 PUFAs, were evaluated for all patients on the 1st, 7th, 14th days after the onset of MI in the blood plasma. Results of the study. On day 14, an increase in the level of prostaglandin I3 in the Omega-3 triglycerides [EPA/DGA — 1.2/1-90%] group was observed in 10 times, the level of thromboxane B3 was increased in 15.9 times, in the absence of significant differences between the groups in the thromboxane B2 and prostaglandin I2 level. A decrease in the ratios of PgI2 / PgI3 and TxB2 / TxB3 in the main group also was noted. Conclusion. Given the lower functional activity of thromboxane B3 and the decrease in the ratio of TxB2 / TxB3, against the background of Omega-3 triglycerides [EPA/DGA — 1.2/1-90%] therapy, one can judge the presence of an independent antiaggregant effect of omega-3-polyunsaturated fatty acids as a result of their use in patients with MI.

omega-3 polyunsaturated fatty acids, thromboxane, prostacyclin, acute myocardial infarction, arachidonic acid cycle

1. Галяутдинов Г.С., Чудакова Е.А. Особенности системы гемостаза у пациентов с ишемической болезнью сердца. Казанский медицинский журнал. 2012; 93(1): 3-7. Galyautdinov G.S., Chudakova E.A. Features of the system of hemostasis in patients with ischemic heart disease. Kazanskiy meditsinskiy zhurnal. 2012; 93(1): 3-7 [in Russian].

2. Говорин А.В., Филев А.П. Омега-3 полиненасыщенные жирные кислоты в лечении больных с сердечнососудистыми заболеваниями. Рациональная Фармакотерапия в Кардиологии. 2012; 8 (1): 95-102. Govorin A.V., Filev A.P. Omega-3 polyunsaturated fatty acids in the treatment in patients with cardiovascular diseases. Ratsionalnaya Farmakoterapiya v Kardiologii. 2012; 8(1): 95-102 [in Russian].

3. Грацианский Н.А. Антитромбоцитарная терапия при коронарной болезни сердца. Некоторые проблемы и достижения. Кардиология. 2010; 6: 4-21. Gratsiansky N.A. Antiplatelet therapy in coronary heart disease. Some problems and achievements. Cardiologia. 2010; 6: 4-21 [in Russian].

4. Карпов Ю.А. ω-3-полиненасыщенные жирные кислоты: применение сегодня и перспективы использования в клинической практике. АтмосферА. Новости кардиологии. 2014; 2: 43-50. Karpov Yu.A. ω-3-polyunsaturated fatty acids: application today and prospects of use in clinical practice. AtmosferA. Novosti kardiologii. 2014; 2: 43-50 [in Russian].

5. Alexander D.D. A meta-analysis of randomized controlled trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic longchain omega-3 fatty acids and coronary heart disease risk. Mayo Clin. Proc. 2017; 92(1): 15–29.

6. Tada M. et al. Elevation of thromboxane B2 levels in patients with classic and variant angina pectoris. Circulation. 1981; 64: 1107–1109.