Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction - PubMed (original) (raw)

Randomized Controlled Trial

. 2012 Jul;33(13):1582-8.

doi: 10.1093/eurheartj/ehr499. Epub 2012 Feb 1.

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Randomized Controlled Trial

Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction

Simone R B M Eussen et al. Eur Heart J. 2012 Jul.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00127452.

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References

    1. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) Lancet. 1994;344:1383–1389. - PubMed
    1. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278. - PubMed
    1. Expert Panel on Detection, Evaluation and, Treatment of High Blood Cholesterol In Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) expert panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) J Am Med Assoc. 2001;285:2486–2497. - PubMed
    1. Ray KK, Cannon CP. The potential relevance of the multiple lipid-independent (pleiotropic) effects of statins in the management of acute coronary syndromes. J Am Coll Cardiol. 2005;46:1425–1433. - PubMed
    1. The U.S. Departments of Agriculture and Health and Human Services. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans. http://www.cnpp.usda.gov/dietaryguidelines.htm. (6 July 2011)

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