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Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction.
Eur Heart J 2012; 33(13):1582-8EH

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.

Authors+Show Affiliations

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

22301766

Citation

Eussen, Simone R B M., et al. "Effects of N-3 Fatty Acids On Major Cardiovascular Events in Statin Users and Non-users With a History of Myocardial Infarction." European Heart Journal, vol. 33, no. 13, 2012, pp. 1582-8.
Eussen SR, Geleijnse JM, Giltay EJ, et al. Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction. Eur Heart J. 2012;33(13):1582-8.
Eussen, S. R., Geleijnse, J. M., Giltay, E. J., Rompelberg, C. J., Klungel, O. H., & Kromhout, D. (2012). Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction. European Heart Journal, 33(13), pp. 1582-8. doi:10.1093/eurheartj/ehr499.
Eussen SR, et al. Effects of N-3 Fatty Acids On Major Cardiovascular Events in Statin Users and Non-users With a History of Myocardial Infarction. Eur Heart J. 2012;33(13):1582-8. PubMed PMID: 22301766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction. AU - Eussen,Simone R B M, AU - Geleijnse,Johanna M, AU - Giltay,Erik J, AU - Rompelberg,Cathy J M, AU - Klungel,Olaf H, AU - Kromhout,Daan, Y1 - 2012/02/01/ PY - 2012/2/4/entrez PY - 2012/2/4/pubmed PY - 2012/10/4/medline SP - 1582 EP - 8 JF - European heart journal JO - Eur. Heart J. VL - 33 IS - 13 N2 - 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. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/22301766/Effects_of_n_3_fatty_acids_on_major_cardiovascular_events_in_statin_users_and_non_users_with_a_history_of_myocardial_infarction_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehr499 DB - PRIME DP - Unbound Medicine ER -