Introduction: Omega-3 polyunsaturated fatty acids (PUFAs) have beneficial effects (i.e., anticoagulation, anti-inflammation, and endothelial dysfunction improvement) against deep vein thromboembolism (DVT). Several studies have demonstrated low omega-3 PUFA levels in patients with DVT. However, whether low omega-3 PUFA level is associated with a new onset of DVT remains unclear.
Methods: We enrolled 115 consecutive patients who underwent surgery for end-stage osteoarthritis of the knee from September 2014 to September 2016. Before and a week after the operation, ultrasonography was performed to determine the presence of DVT. Serum PUFA levels (eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], dihomo-gamma-linolenic acid [DGLA] and arachidonic acid [AA]) were measured at baseline, whereas D-dimer and C-reactive protein levels were measured at baseline and on days 1, 3, 7, and 14 after the surgery.
Results: Of the 115 patients, 14 (12%) showed asymptomatic DVT. Serum EPA and DHA levels in the DVT group were significantly lower than those in the non-DVT group (P < 0.05 for both). Of the remaining 96 patients without preoperative DVT, 35 (36.5%) showed asymptomatic and symptomatic postoperative DVT a week after the surgery. Preoperative EPA level, but not DHA, AA, and DGLA levels, was significantly lower in patients with postoperative DVT (Figure A) and was an independent risk factor for the occurrence of postoperative venous thromboembolism (VTE). Low preoperative EPA level correlated with high postoperative D-dimer levels (Figure B), but not with C-reactive protein levels.
Conclusions: The prevalence of asymptomatic DVT correlated with low omega-3 PUFA levels in patients with end-stage osteoarthritis. Furthermore, low preoperative EPA level was an independent predictor for the new onset of postoperative VTE.