Effects of n-3 fatty acids on major cardiovascular event

Ted_Hutchinson

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May 25, 2009
Effects of n-3 fatty acids on major cardiovascular events in statin users and non-users with a history of myocardial infarction
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 .
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.

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

So if you have had a Heart Attack (myocardial infarction MI) these are the only group for whom there is evidence Statins may be helpful which group had the lowest incidence of a major cardiovascular event over the 7 years of the trial?
Omega 3 groups 9%
Statin users 13%
Statin plus omega 3 users 15%
Placebo 18%
So if you know someone who has had a heart attack would they be safer using omega 3 400mg+2g ALA or a statin?

Now perhaps if you were aware that only a small fraction of the omega 3 in ALA is converted to EPA and an insignficant amount ever gets to DHA, would you think that maybe Dr Davis's suggestion to use 3000mg~6000mg of EPA & DHA from high strength fish oils may indeed be a much safer option than any of those suggested in this trial. Bear in mind Dr Davis recommends this in conjunction with 6000iu/daily vitamin D3, ample magnesium and the use of Niacin.
 


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