Document Detail


Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction.
MedLine Citation:
PMID:  22301766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Recent secondary prevention trials have failed to demonstrate a beneficial effect of n-3 fatty acids on cardiovascular outcomes, which may be due to the growing use of statins since the mid-1990s. The aim of the present study was to assess whether statins modify the effects of n-3 fatty acids on major adverse cardiovascular events in patients with a history of myocardial infarction (MI).
METHODS AND RESULTS: Patients who participated in the Alpha Omega Trial were divided into consistent statin users (n = 3740) and consistent statin non-users (n = 413). In these two groups of patients, the effects of an additional daily amount of 400 mg eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA), 2 g α-linolenic acid (ALA), or both on major cardiovascular events were evaluated. Multivariable Cox's proportional hazard models were used to calculate adjusted hazard rate ratios (HR(adj)). Among the statin users 495 (13%) and among the statin non-users 62 (15%) developed a major cardiovascular event. In statin users, an additional amount of n-3 fatty acids did not reduce cardiovascular events [HR(adj) 1.02; 95% confidence interval (CI): 0.80, 1.31; P = 0.88]. In statin non-users, however, only 9% of those who received EPA-DHA plus ALA experienced an event compared with 18% in the placebo group (HR(adj) 0.46; 95% CI: 0.21, 1.01; P= 0.051).
CONCLUSION: In patients with a history of MI who are not treated with statins, low-dose supplementation with n-3 fatty acids may reduce major cardiovascular events. This study suggests that statin treatment modifies the effects of n-3 fatty acids on the incidence of major cardiovascular events.
Authors:
Simone R B M Eussen; Johanna M Geleijnse; Erik J Giltay; Cathy J M Rompelberg; Olaf H Klungel; Daan Kromhout
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2012-02-01
Journal Detail:
Title:  European heart journal     Volume:  33     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-10-02     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1582-8     Citation Subset:  IM    
Affiliation:
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00127452
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiovascular Agents / administration & dosage*
Cardiovascular Diseases / mortality,  prevention & control*
Dietary Supplements
Double-Blind Method
Drug Interactions
Fatty Acids, Omega-3 / administration & dosage*
Female
Heart Arrest / mortality
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Lipid Metabolism / drug effects
Male
Margarine*
Middle Aged
Myocardial Infarction / complications*
Stroke / mortality
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Fatty Acids, Omega-3; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 8029-82-1/Margarine
Comments/Corrections
Comment In:
Eur Heart J. 2012 Jul;33(13):1555-7   [PMID:  22453655 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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