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Plasma fatty acid profiles and coronary artery disease burden assessed by coronary CT angiography: an observational study
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  • Published: 27 January 2026

Plasma fatty acid profiles and coronary artery disease burden assessed by coronary CT angiography: an observational study

  • Pich Chhay1,2,3,
  • Dantong Zhu1,4,
  • Owen Tang1,2,3,
  • Michael P. Gray1,5,
  • Stephen T. Vernon1,5,
  • Belinda A. Di Bartolo1,2,
  • Katharine A. Kott1,5,
  • Stuart M. Grieve6,7,
  • Robert A. Gibson8,9,
  • Peter J. Psaltis10,11,12 &
  • …
  • Gemma A. Figtree1,2,3,5 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Biomarkers
  • Cardiology

Abstract

Atherosclerotic coronary artery disease (CAD) remains a leading cause of death globally, and individual susceptibility is not fully explained by standard risk factors. The role of plasma fatty acid profiles in relation to imaging-defined CAD burden remains less well established. We performed a cross-sectional cohort analysis of 1,002 participants undergoing coronary computed tomographic angiography (CCTA), with blood samples collected immediately prior to contrast administration. Plasma fatty acids were quantified as a percentage of total plasma fatty acids and evaluated for associations with CAD burden, including coronary artery calcium score (CACS), CACS percentile, Gensini score, soft plaque score, and atrial fibrillation (AF). Associations were assessed using multivariate logistic regression, adjusting for age, sex, and cardiovascular risk factors. Higher plasma omega-6 levels were inversely associated with CACS (CAC+; odds ratio [OR] = 0.93, 95% confidence interval [CI] = 0.90–0.97) with similar inverse associations observed for Gensini and soft plaque scores. In contrast, monounsaturated (CAC + OR = 1.09, 95% CI = 1.03–1.15) and saturated fatty acids (CAC + OR = 1.08, 95% CI = 1.04–1.12) were positively associated with CAD burden. No consistent associations were observed with self-reported atrial fibrillation after multivariable adjustment. Plasma omega-6 fatty acids demonstrated inverse associations with imaging-defined CAD burden, suggesting a potential protective role that warrants investigation in longitudinal studies. Saturated and monounsaturated fatty acids were positively associated with CAD, aligning with prior evidence of their atherogenic potential.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Abbreviations

AF:

Atrial fibrillation

ASCEND:

A study of cardiovascular events in diabetes

BMI:

Body mass index

CACS:

Coronary artery calcium score

CAD:

Coronary artery disease

CI:

Confidence interval

CRP:

C-reactive protein

CCTA:

Coronary computed tomography angiography

DBS:

Dried blood spot

DHA:

Docosahexaenoic acid

EDTA:

Ethylenediaminetetraacetic acid

EPA:

Eicosapentaenoic acid

FAME:

Fatty acid methyl esters

LDL:

Low density lipoprotein

PUFA:

Polyunsaturated fatty acids

REDUCE-IT:

Reduction of cardiovascular events with icosapent ethyl-intervention trial

SD:

Standard deviations

SMuRFs:

Standard modifiable risk factors

SPS:

Soft plaque score

STEMI:

ST-elevation myocardial infarction

STRENGTH:

Statin residual risk reduction with epanova in high cardiovascular risk patients with hypertriglyceridemia

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Acknowledgements

We would like to express our sincere gratitude to all individuals and institutions, particularly the study participants, University of Sydney Charles Perkins Centre, and the South Australian Medical and Research Institute (SAHMRI) whose invaluable contributions and support have made this research possible. We are additionally appreciative for the assistance of the radiographers and nursing staff from North Shore Radiology and Nuclear Medicine in St. Leonards, Australia. We would like to thank Zara Ali, Alexander Bate, Meghan Finemore, Jessica Hu, Tung Nguyen, and Luisa Osorio for their current and historic operational support of the BioHEART study and recruitment of participants included in this analysis.

Funding

The authors are grateful for the following financial support for the research, authorship, and publication of this article. PC is supported by an Australian Government Research Training Program (RTP) Postgraduate Research Scholarship; PJP is supported by a Level 3 Future Leader Fellowship from the National Heart Foundation of Australia (ID106656). GAF is supported by grants from the National Health and Medical Research Council (Australia), Heart Research Australia, and the NSW Office of Health and Medical Research.

Author information

Authors and Affiliations

  1. Cardiovascular Discovery Group, Kolling Institute of Medical Research, Northern Sydney Local Health District, St Leonards, Sydney, NSW, 2065, Australia

    Pich Chhay, Dantong Zhu, Owen Tang, Michael P. Gray, Stephen T. Vernon, Belinda A. Di Bartolo, Katharine A. Kott & Gemma A. Figtree

  2. Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, 2006, Australia

    Pich Chhay, Owen Tang, Belinda A. Di Bartolo & Gemma A. Figtree

  3. Charles Perkins Centre, University of Sydney, Camperdown, Sydney, NSW, 2006, Australia

    Pich Chhay, Owen Tang & Gemma A. Figtree

  4. School of Mathematics and Statistics, University of Sydney, Camperdown, Sydney, NSW, 2006, Australia

    Dantong Zhu

  5. Department of Cardiology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Sydney, NSW, 2065, Australia

    Michael P. Gray, Stephen T. Vernon, Katharine A. Kott & Gemma A. Figtree

  6. Imaging and Phenotyping Laboratory, Charles Perkins Centre, University of Sydney, Camperdown, Sydney, NSW, 2006, Australia

    Stuart M. Grieve

  7. Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2006, Australia

    Stuart M. Grieve

  8. Child Nutrition Research Centre, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia

    Robert A. Gibson

  9. School of Agriculture Food and Wine, Faculty of Sciences, Engineering and Technology, University of Adelaide, Adelaide, SA, 5000, Australia

    Robert A. Gibson

  10. Vascular Research Centre, Lifelong Health, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia

    Peter J. Psaltis

  11. Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia

    Peter J. Psaltis

  12. Department of Cardiology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, 5000, Australia

    Peter J. Psaltis

Authors
  1. Pich Chhay
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Contributions

P.C., O.T., P.P., G.F. conceived and designed the study. O.T., B.D., R.G. acquired the data. P.C., D.Z. conducted the statistical analysis. P.C., D.Z., M.G., S.V., K.K., S.G., P.P., G.F., interpreted the data. All authors reviewed the manuscript and provided final approval for submission.

Corresponding author

Correspondence to Gemma A. Figtree.

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The authors declare no competing interests.

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Chhay, P., Zhu, D., Tang, O. et al. Plasma fatty acid profiles and coronary artery disease burden assessed by coronary CT angiography: an observational study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36845-z

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  • Received: 26 January 2024

  • Accepted: 16 January 2026

  • Published: 27 January 2026

  • DOI: https://doi.org/10.1038/s41598-026-36845-z

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Keywords

  • Plasma fatty acids
  • Omega-6
  • Coronary artery disease
  • Cardiovascular disease
  • Biomarker
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