Adipose Tissue -Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica

Background— -Linolenic acid may protect against cardiovascular disease. We examined the association between adipose tissue -linolenic acid and nonfatal acute myocardial infarction (MI) in a population-based case-control study in Costa Rica. Methods and Results—The 482 case patients with a first nonfatal acute MI and 482 population control subjects were matched by age, sex, and area of residence. Fatty acids were assessed by gas-liquid chromatography in adipose tissue samples collected from all subjects. ORs and 95% CIs were calculated from multivariate conditional logistic regression models. Subjects in the top quintiles of adipose tissue -linolenic acid had a lower risk of MI than those in the lowest quintile: OR (95% CI), 1.00; 0.80 (0.52 to 1.24); 0.53 (0.34 to 0.82); 0.44 (0.28 to 0.67); and 0.37 (0.24 to 0.59); test for trend, P 0.0001. This association was strengthened after adjustment for established MI risk factors, including smoking, physical activity, income, and adipose tissue linoleic acid and trans fatty acids (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.50; test for trend, P 0.0001). Further adjustment for the intake of saturated fat, fiber, alcohol, and vitamin E did not change this association (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.55; test for trend, P 0.0001). Conclusions—The inverse association observed between -linolenic acid and nonfatal acute MI suggests that consumption of vegetable oils rich in -linolenic acid confers important protection against cardiovascular disease. (Circulation. 2003; 107:1586-1591.)