N-3 fatty acid supplementation ineffective for secondary prevention of CAD

January 01, 0001

N-3 fatty acid supplementation ineffective for secondary prevention of CAD

Results from prospective cohort studies and randomized, controlled trials have provided evidence of a protective effect of n-3 fatty acids against cardiovascular diseases. These Dutch authors examined the effect of the marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and of the plant-derived alpha-linolenic acid (ALA) on the rate of cardiovascular events among patients who have had a myocardial infarction in a multicenter, double-blind, placebo-controlled trial. They randomly assigned 4837 patients, 60 through 80 years of age (78% men), who had had a myocardial infarction and were receiving state-of-the-art antihypertensive, antithrombotic, and lipid-modifying therapy to receive for 40 months one of four trial margarines: a margarine supplemented with a combination of EPA and DHA (with a targeted additional daily intake of 400 mg of EPA-DHA), a margarine supplemented with ALA (with a targeted additional daily intake of 2 g of ALA), a margarine supplemented with EPA-DHA and ALA, or a placebo margarine.

They found: "The patients consumed, on average, 18.8 g of margarine per day, which resulted in additional intakes of 226 mg of EPA combined with 150 mg of DHA, 1.9 g of ALA, or both, in the active-treatment groups. During the follow-up period, a major cardiovascular event occurred in 671 patients (13.9%). Neither EPA-DHA nor ALA reduced this primary end point. In the prespecified subgroup of women, ALA, as compared with placebo and EPA-DHA alone, was associated with a reduction in the rate of major cardiovascular events that approached significance (hazard ratio, 0.73, P=0.07). The rate of adverse events did not differ significantly among the study groups."

The authors concluded: "Low-dose supplementation with EPA-DHA or ALA did not significantly reduce the rate of major cardiovascular events among patients who had had a myocardial infarction and who were receiving state-of-the-art antihypertensive, antithrombotic, and lipid- modifying therapy."

N-3 fatty acid supplementation didn’t work.

For the full abstract, click here.

N Engl J Med 363:2015-2026, 18 November 2010 © 2010 to the Massachusetts Medical Society
N-3 Fatty Acids and Cardiovascular Events after Myocardial Infarction. Daan Kromhout, Erik J. Giltay, and Johanna M. Geleijnse, for the Alpha Omega Trial Group. Correspondence to Dr. Kromhout: [email protected]

Category: K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: coronary artery disease, myocardial infarction, n-3 fatty acids, eicosapentaenoic acid, docosahexaenoic acid, alpha-linolenic acid, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.