Fish, fish oil supplement, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and in some cases alpha-linolenic acid (ALA) intake have been associated with reduced risk of cardiovascular events and death.

The association between n-3 fatty acids in plasma lipids and progression of coronary-artery atherosclerosis was assessed among women with established coronary artery disease (CAD).

A prospective cohort study involved postmenopausal women (n=228) participating in the Estrogen Replacement and Atherosclerosis trial.

Quantitative coronary angiography was performed at baseline and after 3.2±0.6 (mean±SD) years. Women with plasma phospholipid DHA levels above the median, compared to below, exhibited less atherosclerosis progression as expressed by decline in minimum coronary artery diameter (-0.04±0.02 mm and -0.10±0.02 mm, respectively, P=0.007), or increase in percent stenosis (1.34±0.76% and 3.75±0.74%, respectively, P=0.006) and had fewer new lesions [2.0 (0.5-3.5) % of measured segments (95% confidence interval)] and 4.2 (2.8-5.6)%, respectively, P=0.009] after adjustments for cardiovascular risk factors.

Similar results were observed for DHA in the triglycerides. EPA and ALA in plasma lipids were not significantly associated with atherosclerosis progression.

Consistent with higher reported fish intake, higher levels of plasma triglyceride and phospholipid DHA is associated with less progression of coronary atherosclerosis in postmenopausal women with established CAD.