Association of circulating factor seven activating protease (FSAP) and of oral Omega-3 fatty acids supplements with clinical outcome in patients with atrial fibrillation: the OMEGA-AF study

• Published in: Journal of thrombosis and thrombolysis Vol. 37; no. 3; pp. 317 - 325
• Main Authors: Parahuleva, Mariana S., Kanse, Sandip, Hölschermann, Hans, Zheleva, Kirila, Zandt, Daniel, Worsch, Michael, Parviz, Behnoush, Güttler, Norbert, Tillmanns, Harald, Böning, Andreas, Erdogan, Ali
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.04.2014; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Atrial Fibrillation - blood; Atrial Fibrillation - diet therapy; Cardiology; Dietary Supplements; Double-Blind Method; Fatty Acids, Omega-3 - administration & dosage; Female; Follow-Up Studies; Hematology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Serine Endopeptidases - blood; Inflammation; FSAP; Atrial fibrillation; Thrombogenesis; Atrial remodelling; Omega-3 fatty acid
• ISSN: 0929-5305; 1573-742X
• DOI: 10.1007/s11239-013-0921-0

Factor VII Activating Protease (FSAP) activates factor VII (FVII) as well as pro-urokinase (uPA). Our goal was to evaluate the relation between plasma levels of FSAP and clinical instability in atrial fibrillation (AF) and possible effects of oral omega-3 fatty acids (FA) supplements. 101 patients with persistent AF were analyzed in the OMEGA-AF Study. Plasma FSAP levels were measured at baseline and after 12 weeks of treatment with omega-3 FA. The median FSAP antigen concentration, in contrast to FSAP activity, was higher in patients with persistent AF. The maintenance of SR after successful cardioversion (CV) did not lead to a normalization of FSAP concentration. Supplementation with omega-3 FA but not placebo significantly reduced elevated FSAP concentration. Furthermore, elevated FSAP levels did not indicate a significantly increased risk of recurrence of AF after electrical CV or cardiovascular clinical events during 1 year of follow-up. Plasma FSAP concentration was increased in patients with AF and may be involved in the pathogenesis of this condition. The possible effects of omega-3 FA on clinical AF potential could be linked with modulation of circulating FSAP levels.