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Antiarrhythmic mechanisms of n-3 PUFA and the results of the GISSI-Prevenzione trial.
J Membr Biol. 2005 Jul; 206(2):117-28.JM

Abstract

The purpose of this paper is twofold: on the one hand, to confirm the positive results on n-3 PUFA from the overall results Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GlSSI)-Prevenzione trial; on the other, to summarize and describe how the results of an important trial can help generate hypotheses either on mechanisms of action or on differential results in particular subgroups of patients, as well as test the pathophysiological hypotheses that have accompanied in the years the story of the hypothesized mechanisms of action of a drug. GISSI-Prevenzione was conceived as a pragmatic population trial on patients with recent myocardial infarction and it was conducted in the framework of the Italian public health system. In GISSI-Prevenzione, 11,323 patients were enrolled in a clinical trial aimed at testing the effectiveness of n-3 polyunsaturated fatty acids (PUFA) and vitamin E. Patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term n-3 PUFA at 1 g daily, but not vitamin E at 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall (-20%), cardiovascular (-30%), and sudden death (-45%). At variance from the orientation of a scientific scenario largely dominated by the "cholesterol-heart hypothesis", GISSI-Prevenzione results indicate n-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction.

Authors+Show Affiliations

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 available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16456722

Citation

Marchioli, R, et al. "Antiarrhythmic Mechanisms of N-3 PUFA and the Results of the GISSI-Prevenzione Trial." The Journal of Membrane Biology, vol. 206, no. 2, 2005, pp. 117-28.
Marchioli R, Levantesi G, Macchia A, et al. Antiarrhythmic mechanisms of n-3 PUFA and the results of the GISSI-Prevenzione trial. J Membr Biol. 2005;206(2):117-28.
Marchioli, R., Levantesi, G., Macchia, A., Maggioni, A. P., Marfisi, R. M., Silletta, M. G., Tavazzi, L., Tognoni, G., & Valagussa, F. (2005). Antiarrhythmic mechanisms of n-3 PUFA and the results of the GISSI-Prevenzione trial. The Journal of Membrane Biology, 206(2), 117-28.
Marchioli R, et al. Antiarrhythmic Mechanisms of N-3 PUFA and the Results of the GISSI-Prevenzione Trial. J Membr Biol. 2005;206(2):117-28. PubMed PMID: 16456722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiarrhythmic mechanisms of n-3 PUFA and the results of the GISSI-Prevenzione trial. AU - Marchioli,R, AU - Levantesi,G, AU - Macchia,A, AU - Maggioni,A P, AU - Marfisi,R M, AU - Silletta,M G, AU - Tavazzi,L, AU - Tognoni,G, AU - Valagussa,F, AU - ,, PY - 2005/09/08/received PY - 2006/2/4/pubmed PY - 2006/3/1/medline PY - 2006/2/4/entrez SP - 117 EP - 28 JF - The Journal of membrane biology JO - J. Membr. Biol. VL - 206 IS - 2 N2 - The purpose of this paper is twofold: on the one hand, to confirm the positive results on n-3 PUFA from the overall results Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GlSSI)-Prevenzione trial; on the other, to summarize and describe how the results of an important trial can help generate hypotheses either on mechanisms of action or on differential results in particular subgroups of patients, as well as test the pathophysiological hypotheses that have accompanied in the years the story of the hypothesized mechanisms of action of a drug. GISSI-Prevenzione was conceived as a pragmatic population trial on patients with recent myocardial infarction and it was conducted in the framework of the Italian public health system. In GISSI-Prevenzione, 11,323 patients were enrolled in a clinical trial aimed at testing the effectiveness of n-3 polyunsaturated fatty acids (PUFA) and vitamin E. Patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term n-3 PUFA at 1 g daily, but not vitamin E at 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall (-20%), cardiovascular (-30%), and sudden death (-45%). At variance from the orientation of a scientific scenario largely dominated by the "cholesterol-heart hypothesis", GISSI-Prevenzione results indicate n-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction. SN - 0022-2631 UR - https://www.unboundmedicine.com/medline/citation/16456722/Antiarrhythmic_mechanisms_of_n_3_PUFA_and_the_results_of_the_GISSI_Prevenzione_trial_ L2 - https://dx.doi.org/10.1007/s00232-005-0788-x DB - PRIME DP - Unbound Medicine ER -