Circulating long and very long-chain saturated fatty acids and heart failure: Results from a large US cohort study.

Authors

Azra Ramezankhani, Parto Hadaegh, Behnaz Abiri, Farzad Hadaegh

Published in

Journal of clinical lipidology. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

Elevated saturated fatty acids (SFAs) have generally been associated with higher cardiovascular risk, whereas emerging evidence suggests that long- and very-long-chain SFAs (LVLSFAs) may be inversely associated with cardiometabolic outcomes.
This study aimed to investigate the associations of circulating LVLSFAs with incident heart failure (HF) in a prospective US cohort.
We conducted a prospective analysis of 6408 participants from the Multi-Ethnic Study of Atherosclerosis cohort (2002-2015). Plasma phospholipid fatty acids (FAs) were measured and expressed as % of total FAs. Cox proportional hazards models, adjusted for established risk factors, estimated hazard ratios (HRs) and 95% CIs for associations between LVLSFAs (as both continuous and quartile) and HF.
Over a median follow-up of 14 years, 320 cases of HF were identified. Significant inverse associations were observed between incident HF and a 1% increase in the concentration of SFAs (expressed as a percentage of total FAs) for C18:0 (0.91; 0.84-0.98), C20:0 (0.19; 0.06-0.57), and C22:0 (0.62; 0.44-0.87). Quartile analyses revealed that participants in the Q3 of C18:0 had a 30% lower risk of HF compared to the Q1 (0.70, 0.50-0.98). For C20:0 and C22:0, the strongest inverse associations were observed in the Q4 vs Q1, with HRs of 0.61 (0.43-0.84) and 0.62 (0.44-0.87), respectively. These associations were consistent across subgroups by sex, age, race, body mass index, smoking status, and hypertension, with a stronger inverse association for C18:0 among participants with diabetes (P interaction = .007).
These results highlight VLCSFAs as promising biomarkers for HF risk stratification and warrant further investigation into the underlying biological mechanisms.

PMID:
42629239
Bibliographic data and abstract were imported from PubMed on 22 Aug 2026.

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