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Different lipid mediators may have opposing effects on vascular inflammation. For example, whereas leukotriene B4 (LTB4) transduces inflammation, resolvin D1 (RvD1), which is synthesized from the omega-3 fatty acid docosahexaenoic acid, facilitates the resolution of inflammation. The aim of this study was to determine the association of the RvD1/LTB4 ratio with subclinical atherosclerosis.Saliva samples and ultrasound measurements of the intima media thickness of the carotid artery was obtained for 254 participants. The lipid mediators RvD1 and LTB4 were measured by enzyme-linked immunosorbent assay.Participants with a salivary RvD1/LTB4 ratio >1 had a significantly lower intima media thickness than those in whom LTB4 prevailed. The salivary RvD1/LTB4 ratio independently predicted carotid intima media thickness.The ratio between the proresolving and proinflammatory salivary lipid mediators RvD1 and LTB4 may serve as a biomarker of non-resolving inflammation and its relation to intima media thickness in cardiovascular disease.