Free fatty acids as a marker for predicting periprocedural myocardial injury after coronary intervention.

Background: Previous studies have revealed that plasma levels of free fatty acids (FFAs) are related to cardiovascular risk. However, whether FFAs could predict periprocedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) remains unclear.

Purpose: This study aimed to investigate the relationship of FFAs to PMI in untreated patients with CAD who underwent PCI.

Methods: A total of 374 consecutive patients with CAD without lipid-lowering treatment on admission and with normal preprocedural cardiac troponin I (cTnI) levels who underwent PCI were prospectively enrolled. The baseline characteristics were collected and PMI was evaluated by cTnI analysis within 24 hours. The relation of preprocedural FFA levels to peak cTnI values after PCI was examined.

Results: Preprocedural FFAs were positively correlated with peak cTnI values after PCI in both simple regression model (β=0.119, p=0.021) and multiple regression model (β=0.198, p=0.001). Patients with higher FFA levels had higher postprocedural cTnI levels compared with those with normal FFA levels (0.27±0.68 ng/mL vs 0.66±0.31 ng/mL, p=0.014). In the multivariable model, preprocedural FFA levels were associated with an increased risk of postprocedural cTnI elevation above 1× upper limit of normal (ULN, OR: 1.185, 95% CI 0.997 to 1.223, p=0.019) up to 10× ULN (OR: 1.132, 95% CI 1.005 to 1.192, p=0.003) .

Conclusions: The present study first suggested that elevated FFA levels were associated with an increased risk of PMI in untreated patients with CAD. Further study with large sample size may be needed to confirm our findings.