Omega-3 fatty acid therapy is a promising intervention for the secondary prevention
of coronary artery disease (CAD). Omega-3 fatty acids have properties that promote
atherosclerotic plaque stability and decrease the incidence of ischemia-driven cardiac
arrhythmias. A large number of clinical trials conducted in patients with CAD or prior
myocardial infarction (MI) have examined hard cardiovascular end points, including
total mortality, cardiovascular mortality, sudden death, and nonfatal MI. Several
intermediate cardiovascular end-point studies have also examined whether ventricular
arrhythmias can be suppressed in patients with implantable cardioverter defibrillators
(ICDs). Significant reductions in total mortality and sudden death—20% to 50%—have
been found in studies using doses of 0.85 to 4.0 g/day, with treatment durations from
12 to 42 months. Favorable trends toward reduction in the incidence of arrhythmic
events have been demonstrated in some, but not all, ICD studies. Omega-3 fatty acid
therapy shows a general positive trend toward benefit in reducing life-threatening
events after MI and in patients with ICDs who have ischemic arrhythmias. Results of
the recent Japan EPA Lipid Intervention Study (JELIS) in a large cohort (N = 18,645)
of Japanese men and women suggest significant benefits in the reduction of unstable
angina and nonfatal coronary events. The totality of evidence supports a strong role
for omega-3 fatty acids derived from fish oil in secondary prevention through a presumptive
role as an antiarrhythmic agent and through an ability to promote plaque stabilization.
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References
- Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction.Lancet. 1999; 354 ([published correction appears in Lancet 2001;357:642]): 447-455
- Early protection against sudden death by n-3 fatty acids after myocardial infarction.Circulation. 2002; 105: 1897-1903
- Left ventricular systolic dysfunction, total mortality, and sudden death in patients with myocardial infarction treated with n-3 polyunsaturated fatty acids.Eur J Heart Fail. 2005; 7: 904-909
- Effect of different antilipidemic agents and diets on mortality.Arch Intern Med. 2005; 165: 725-730
- N-3 polyunsaturated fatty acids in coronary heart disease.Am J Med. 2002; 112: 298-304
- Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators.JAMA. 2005; 293: 2884-2891
- Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction.Lancet. 1989; 2: 757-761
- Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction.Cardiovasc Drugs Ther. 1997; 11: 485-491
- Effects of a high-dose concentrate of n-3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol.Am J Clin Nutr. 2001; 74: 50-56
- The effect of dietary omega-3 fatty acids on coronary atherosclerosis.Ann Intern Med. 1999; 130: 554-562
- Randomized controlled trial of gamma-linolenic acid and eicosapentaenoic acid in peripheral arterial disease.Clin Nutr. 1998; 17: 265-271
- Controlled trial of fish oil for regression of human coronary atherosclerosis.J Am Coll Cardiol. 1995; 25: 1492-1498
Yokoyama M. Effects of eicosapentaenoic acid (EPA) on major cardiovascular events in hypercholesterolemic patients: the Japan EPA Lipid Intervention Study (JELIS). Presented at the American Heart Association Scientific Sessions; November 14, 2005; Dallas, TX.
- Effects of eicosapentaenoic acid on cardiovascular events in Japanese patients with hypercholesterolemia.Am Heart J. 2003; 146: 613-620
- Prevention of sudden cardiac death by omega-3 polyunsaturated fatty acids.Pharmacol Ther. 2003; 98: 355-377
- Dietary intake of long-chain omega-3 polyunsaturated fatty acids and the risk of primary cardiac arrest.Am J Clin Nutr. 2000; 71: 208S-212S
- N-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery.J Am Coll Cardiol. 2005; 45: 1723-1728
- Rationale and design of a randomised controlled clinical trial on supplemental intake of omega-3 fatty acids and incidence of cardiac arrhythmia.Eur J Clin Nutr. 2003; 57: 1323-1330
- Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake.Circulation. 2005; 112: 2762-2768
Brouwer I. SOFA: Study on Omega-3 Fatty Acid and Ventricular Arrhythmia. Presented at the European Society of Cardiology Congress; September 5, 2005; Stockholm, Sweden.
- Usefulness of omega-3 fatty acids and the prevention of coronary heart disease.Am J Cardiol. 2005; 96: 1521-1529
- n-3 Fatty acids in the prevention of cardiac arrhythmias.Lipids. 1999; 34: S187-S189
- Modulation of dihydropyridine-sensitive calcium channels in heart cells by fish oil fatty acids.Proc Natl Acad Sci U S A. 1992; 89: 1760-1764
- The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans.Am J Clin Nutr. 2002; 76: 326-330
- Influence of dietary supplementation with long-chain n-3 or n-6 polyunsaturated fatty acids on blood inflammatory cell populations and functions and on plasma soluble adhesion molecules in healthy adults.Lipids. 2001; 36: 1183-1193
- Effect of fish oil on heart rate in humans.Circulation. 2005; 112: 1945-1952
- Clinical trials update from the European Society of Cardiology meeting 2005.Eur J Heart Fail. 2005; 7: 1070-1075
- Rationale and design of the GISSI Heart Failure trial.Eur J Heart Fail. 2004; 6: 635-641
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Published online: May 30, 2006
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© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
