Tags

Type your tag names separated by a space and hit enter

Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione.
Circulation. 2002 Apr 23; 105(16):1897-903.Circ

Abstract

BACKGROUND

Our purpose was to assess the time course of the benefit of n-3 polyunsaturated fatty acids (PUFAs) on mortality documented by the GISSI-Prevenzione trial in patients surviving a recent (<3 months) myocardial infarction.

METHODS AND RESULTS

In this study, 11 323 patients were randomly assigned to supplements of n-3 PUFAs, vitamin E (300 mg/d), both, or no treatment (control) on top of optimal pharmacological treatment and lifestyle advice. Intention-to-treat analysis adjusted for interaction between treatments was carried out. Early efficacy of n-3 PUFA treatment for total, cardiovascular, cardiac, coronary, and sudden death; nonfatal myocardial infarction; total coronary heart disease; and cerebrovascular events was assessed by right-censoring follow-up data 12 times from the first month after randomization up to 12 months. Survival curves for n-3 PUFA treatment diverged early after randomization, and total mortality was significantly lowered after 3 months of treatment (relative risk [RR] 0.59; 95% CI 0.36 to 0.97; P=0.037). The reduction in risk of sudden death was specifically relevant and statistically significant already at 4 months (RR 0.47; 95% CI 0.219 to 0.995; P=0.048). A similarly significant, although delayed, pattern after 6 to 8 months of treatment was observed for cardiovascular, cardiac, and coronary deaths.

CONCLUSIONS

The early effect of low-dose (1 g/d) n-3 PUFAs on total mortality and sudden death supports the hypothesis of an antiarrhythmic effect of this drug. Such a result is consistent with the wealth of evidence coming from laboratory experiments on isolated myocytes, animal models, and epidemiological and clinical studies.

Authors+Show Affiliations

Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy. marchioli@negrisud.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11997274

Citation

Marchioli, Roberto, et al. "Early Protection Against Sudden Death By N-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-course Analysis of the Results of the Gruppo Italiano Per Lo Studio Della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione." Circulation, vol. 105, no. 16, 2002, pp. 1897-903.
Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105(16):1897-903.
Marchioli, R., Barzi, F., Bomba, E., Chieffo, C., Di Gregorio, D., Di Mascio, R., Franzosi, M. G., Geraci, E., Levantesi, G., Maggioni, A. P., Mantini, L., Marfisi, R. M., Mastrogiuseppe, G., Mininni, N., Nicolosi, G. L., Santini, M., Schweiger, C., Tavazzi, L., Tognoni, G., ... Valagussa, F. (2002). Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation, 105(16), 1897-903.
Marchioli R, et al. Early Protection Against Sudden Death By N-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-course Analysis of the Results of the Gruppo Italiano Per Lo Studio Della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002 Apr 23;105(16):1897-903. PubMed PMID: 11997274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. AU - Marchioli,Roberto, AU - Barzi,Federica, AU - Bomba,Elena, AU - Chieffo,Carmine, AU - Di Gregorio,Domenico, AU - Di Mascio,Rocco, AU - Franzosi,Maria Grazia, AU - Geraci,Enrico, AU - Levantesi,Giacomo, AU - Maggioni,Aldo Pietro, AU - Mantini,Loredana, AU - Marfisi,Rosa Maria, AU - Mastrogiuseppe,G, AU - Mininni,Nicola, AU - Nicolosi,Gian Luigi, AU - Santini,Massimo, AU - Schweiger,Carlo, AU - Tavazzi,Luigi, AU - Tognoni,Gianni, AU - Tucci,Corrado, AU - Valagussa,Franco, AU - ,, PY - 2002/5/9/pubmed PY - 2002/5/17/medline PY - 2002/5/9/entrez SP - 1897 EP - 903 JF - Circulation JO - Circulation VL - 105 IS - 16 N2 - BACKGROUND: Our purpose was to assess the time course of the benefit of n-3 polyunsaturated fatty acids (PUFAs) on mortality documented by the GISSI-Prevenzione trial in patients surviving a recent (<3 months) myocardial infarction. METHODS AND RESULTS: In this study, 11 323 patients were randomly assigned to supplements of n-3 PUFAs, vitamin E (300 mg/d), both, or no treatment (control) on top of optimal pharmacological treatment and lifestyle advice. Intention-to-treat analysis adjusted for interaction between treatments was carried out. Early efficacy of n-3 PUFA treatment for total, cardiovascular, cardiac, coronary, and sudden death; nonfatal myocardial infarction; total coronary heart disease; and cerebrovascular events was assessed by right-censoring follow-up data 12 times from the first month after randomization up to 12 months. Survival curves for n-3 PUFA treatment diverged early after randomization, and total mortality was significantly lowered after 3 months of treatment (relative risk [RR] 0.59; 95% CI 0.36 to 0.97; P=0.037). The reduction in risk of sudden death was specifically relevant and statistically significant already at 4 months (RR 0.47; 95% CI 0.219 to 0.995; P=0.048). A similarly significant, although delayed, pattern after 6 to 8 months of treatment was observed for cardiovascular, cardiac, and coronary deaths. CONCLUSIONS: The early effect of low-dose (1 g/d) n-3 PUFAs on total mortality and sudden death supports the hypothesis of an antiarrhythmic effect of this drug. Such a result is consistent with the wealth of evidence coming from laboratory experiments on isolated myocytes, animal models, and epidemiological and clinical studies. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/11997274/Early_protection_against_sudden_death_by_n_3_polyunsaturated_fatty_acids_after_myocardial_infarction:_time_course_analysis_of_the_results_of_the_Gruppo_Italiano_per_lo_Studio_della_Sopravvivenza_nell'Infarto_Miocardico__GISSI__Prevenzione_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.cir.0000014682.14181.f2?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -