Omega-3 Fatty Acids and Markers of Thrombosis in Patients with Atrial Fibrillation.

Omega-3 fatty acids (n-3 FAs) are associated with a lower risk of ischemic stroke in patients with atrial
fibrillation (AF). Antithrombotic mechanisms may in part explain this observation. Therefore, we
examined the association of n-3 FAs with D-dimer and beta-thromboglobulin (BTG), markers for
activated coagulation and platelets, respectively. The n-3 FAs eicosapentaenoic acid (EPA),
docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and alpha-linolenic acid (ALA) were
determined via gas chromatography in the whole blood of 2373 patients with AF from the Swiss Atrial
Fibrillation cohort study. In a cross-sectional analysis, we examined the association of total n-3 FAs (EPA
+ DHA + DPA + ALA) and the association of individual fatty acids with D-dimer in patients with detectable
D-dimer values (n = 1096) as well as with BTG (n = 2371) using multiple linear regression models adjusted for confounders. Median D-dimer and BTG levels were 0.340 ug/mL and 448 ng/mL,
respectively. Higher total n-3 FAs correlated with lower D-dimer levels (coefficient 0.94, 95% confidence
interval (Cl) 0.90-0.98, p = 0.004) and lower BTG levels (coefficient 0.97, Cl 0.95-0.99, p = 0.003).
Likewise, the individual n-3 FAs EPA, DHA, DPA and ALA showed an inverse association with D-dimer.
Higher levels of DHA, DPA and ALA correlated with lower BTG levels, whereas EPA showed a positive
association with BTG. In patients with AF, higher levels of n-3 FAs were associated with lower levels of D-
dimer and BTG, markers for activated coagulation and platelets, respectively. These findings suggest
that n-3 FAs may exert antithrombotic properties in patients with AF.