Document Detail


Highly purified omega-3 polyunsaturated fatty acids are effective as adjunct therapy for secondary prevention of myocardial infarction.
MedLine Citation:
PMID:  17575805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione was the first large randomized trial to produce evidence that a pharmaceutical preparation of highly purified omega-3 polyunsaturated fatty acids (PUFAs), administered as an adjunct to other accepted interventions, had a favorable effect on hard clinical end-points in post-myocardial infarction patients. Much of the 20% all-cause mortality benefit recorded during the study could be attributed to a 45% reduction in sudden death--a fatal outcome that traditionally has proved resistant to medical intervention. These results were obtained with an omega-3 PUFA dose of 1 g/day, which is much lower than was routinely being used at the time the study was initiated (e.g. 4 g/day for hypertriglyceridemia). One consequence of this low-dose regimen was that the tolerability profile of omega-3 PUFAs during GISSI-Prevenzione was considered highly satisfactory, with low adverse event incidence rates and low rates of discontinuation due to adverse events. Time-course analysis established that much of the survival benefit of omega-3 PUFA treatment in GISSI-Prevenzione was realized during the early months of the trial. The beneficial effects of omega-3 PUFA treatment were observed on top of standard, secondary pharmacological prevention therapy like anti-platelet agents, statins, beta-blockers and angiotensin-converting enzyme (ACE) inhibitors. The benefits of omega-3 PUFA therapy were also apparent in patients at all standards of adherence to a healthy diet and may have been augmented in patients with the best dietary profile. Patients with diabetes mellitus (approximately 15% of the study cohort) appeared to benefit from omega-3 PUFAs to at least the same extent as the general study population; the treatment effect on sudden death was progressively more pronounced as left ejection fraction declined. Cost-effectiveness analyses undertaken from a third-party payer perspective for Italy revealed that the cost of low-dose treatment with highly purified omega-3 PUFAs was approximately Euro 25,000 per life-year gained.
Authors:
Cees N Verboom;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Herz     Volume:  31 Suppl 3     ISSN:  0340-9937     ISO Abbreviation:  Herz     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-06-19     Completed Date:  2007-07-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7801231     Medline TA:  Herz     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  49-59     Citation Subset:  IM    
Affiliation:
Solvay Pharmaceuticals, Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Chemotherapy, Adjuvant
Dietary Fats / therapeutic use*
Fatty Acids, Omega-3 / economics,  therapeutic use*
Female
Humans
Italy / epidemiology
Male
Middle Aged
Myocardial Infarction / drug therapy,  economics,  epidemiology*,  prevention & control*
Randomized Controlled Trials as Topic
Risk Assessment / methods*
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Dietary Fats; 0/Fatty Acids, Omega-3

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


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