Omega-3 fatty acids for cardiovascular disease prevention

Current Treatment Options in Cardiovascular Medicine

Volumn 12, Issue 4, 2010, Pages 365-380

  DeFilippis, Andrew Paul ^a   Blaha, Michael J ^a   Jacobson, Terry A ^a  

^a JOHNS HOPKINS UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ALPHA TOCOPHEROL; ATORVASTATIN; C REACTIVE PROTEIN; CLOPIDOGREL; DIOXIN; DOCOSAHEXAENOIC ACID; FISH OIL; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; ICOSAPENTAENOIC ACID; INTERLEUKIN 6; LINOLENIC ACID; METHYLMERCURY; OMEGA 3 FATTY ACID; PLACEBO; POLYCHLORINATED BIPHENYL; SIMVASTATIN; STROMELYSIN; THROMBOXANE A2; TUMOR NECROSIS FACTOR ALPHA;

ADJUVANT THERAPY; ANTIINFLAMMATORY ACTIVITY; ARTICLE; BLEEDING; CARDIOVASCULAR DISEASE; CLINICAL TRIAL; CONGESTIVE HEART FAILURE; CONTAMINATED FISH; DEFIBRILLATOR; DIET SUPPLEMENTATION; DIETARY REFERENCE INTAKE; FATTY ACID METABOLISM; GASTROINTESTINAL SYMPTOM; HEART ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART FAILURE; HEART PROTECTION; HUMAN; HYPERCHOLESTEROLEMIA; HYPERTRIGLYCERIDEMIA; ISCHEMIC HEART DISEASE; MEDITERRANEAN DIET; PRIMARY PREVENTION; SECONDARY PREVENTION; TELOMERE; THROMBOCYTE AGGREGATION INHIBITION; WATER POLLUTANT;

EID: 78650211892     PISSN: 10928464     EISSN: None     Source Type: Journal    
DOI: 10.1007/s11936-010-0079-4     Document Type: Article

References (60)

1. Dyerberg J, Bang HO, Stoffersen E, et al.: Eicosapentaenoic acid and prevention of thrombosis and atherosclerosis? Lancet 1978, 2(8081):117-119.
2. Albert CM, Campos H, Stampfer MJ, et al.: Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002, 346(15):1113-1118.
3. Albert CM, Hennekens CH, O'Donnell CJ, et al.: Fish consumption and risk of sudden cardiac death. JAMA 1998, 279(1):23-28.
4. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999, 354(9177):447-455
5. [Published erratum appears in Lancet 2001, 357(9256):642].
6. Ascherio A, Rimm EB, Stampfer MJ, et al.: Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med 1995, 332(15):977-982.
7. DeFilippis AP, Sperling LS: Understanding omega-3's. Am Heart J 2006, 151(3):564-570.
8. Kris-Etherton PM, Harris WS, Appel LJ, American Heart Association: Nutrition C: Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002, 106(21):2747-2757 [Published erratum appears in Circulation 2003, 107(3):512].
9. [Published erratum appears in Circulation 2003, 107(3):512]
10. Kromhout D, Bosschieter EB, de Lezenne Coulander C: The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 1985, 312(19):1205-1209.
11. Yokoyama M, Origasa H, Matsuzaki M, et al.; Japan EPA lipid intervention study (JELIS) Investigators: Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007, 369(9567):1090-1098. The JELIS trial randomly assigned 18, 645 patients with hypercholesterolemia to receive a statin plus purified EPA (1800 mg/d) or a statin plus placebo. After an average of 4.6 years of follow-up, those assigned to a statin plus purified EPA received a 19% relative risk reduction in the combined primary outcome of sudden cardiac death, fatal and nonfatal myocardial infarction, unstable angina, and coronary revascularization compared with those treated with a statin plus placebo. JELIS was the first omega-3 trial to include subjects without known CVD, the first to show benefit beyond uniform statin treatment, and the first to show benefit with EPA supplementation alone (as opposed to EPA + DHA)
12. Lev ES, Harel A, Mager N, et al.: Treatment of aspirinresistant patients with omega-3 fatty acids versus aspirin dose escalation. J Am Coll Cardiol 2010, 55(2):114.
13. Farzaneh-Far R, Harris WS, Garg S, et al.: Inverse association of erythrocyte n-3 fatty acid levels with inflammatory biomarkers in patients with stable coronary artery disease: The Heart and Soul Study. Atherosclerosis 2009, 205(2):538-543.
14. Farzaneh-Far R, Lin J, Epel ES, et al.: Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease. JAMA 303(3):250-257
15. He K, Liu K, Daviglus ML, et al.: Associations of dietary long-chain n-3 polyunsaturated fatty acids and fish with biomarkers of inflammation and endothelial activation (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2009, 103(9):1238-1243.
16. Lopez-Garcia E, Schulze MB, Manson JE, et al.: Consumption of (n-3) fatty acids is related to plasma biomarkers of inflammation and endothelial activation in women. J Nutr 2004, 134(7):1806-1811.
17. Micallef MA, Munro IA, Garg ML: An inverse relationship between plasma n-3 fatty acids and C-reactive protein in healthy individuals. EurJ Clin Nutr 2009, 63(9):1154-1156.
18. Pischon T, Hankinson SE, Hotamisligil GS, et al.: Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003, 108(2):155-160.
19. Kris-Etherton PM, Grieger JA, Etherton TD: Dietary reference intakes for DHA and EPA. Prostaglandins Leukot Essent Fat Acids 2009, 81 (2-3): 99-104.
20. Lavie CJ, Milani RV, Mehra MR, Ventura HO: Omega-3 polyunsaturated fatty acids and cardiovascular diseases. J Am Coll Cardiol 2009, 54(7):585-594.
21. Mozaffarian D: Fish, mercury, selenium and cardiovascular risk: current evidence and unanswered questions. Int J Environ Res Public Health 2009, 6(6):1894-1916. This comprehensive review examines the evidence that contaminants often found in fish (methyl mercury, PCBs, and dioxins) cause harm. The authors provide statistical analysis to compare the potential risk from these pollutants with the appreciable benefits of eating fish
22. Rawn DF, Breakell K, Verigin V, et al.: Persistent organic pollutants in fish oil supplements on the Canadian market: polychlorinated biphenyls and organochlorine insecticides. J Food Sci 2009, 74(1):T14-T19.
23. Burdge G: Alpha-linolenic acid metabolism in men and women: nutritional and biological implications. Curr Opin Clin Nutr Metab Care 2004, 7(2):137-144.
24. DeFilippis AP, Harper CR, Cotsonis GA, Jacobson TA: Effect of baseline plasma fatty acids on eicosapentaenoic acid levels in individuals supplemented with alpha-linolenic acid. Int J Food Sci Nutr 2009, 60 (Suppl 5):28-37.
25. Emken EA, Adlof RO, Gulley RM: Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochim Biophys Acta 1994, 1213(3):277-288.
26. Gerster H: Can adults adequately convert alphalinolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)? Int J Vitam Nutr Res 1998, 68(3):159-173.
27. Goyens PL, Spilker ME, Zock PL, et al.: Conversion of alpha-linolenic acid in humans is influenced by the absolute amounts of alpha-linolenic acid and linoleic acid in the diet and not by their ratio. Am J Clin Nutr 2006, 84(1):44-53.
28. Harper CR, Edwards MJ, DeFilipis AP, Jacobson TA: Flaxseed oil increases the plasma concentrations of cardioprotective (n-3) fatty acids in humans. J Nutr 2006, 136(1):83-87.
29. Layne KS, Goh YK, Jumpsen JA, et al.: Normal subjects consuming physiological levels of 18:3 (n-3) and 20:5 (n-3) from flaxseed or fish oils have characteristic differences in plasma lipid and lipoprotein fatty acid levels. J Nutr 1996, 126(9):2130-2140.
30. Sprecher H: An update on the pathways of polyunsaturated fatty acid metabolism. Curr Opin Clin Nutr Metab Care 1999, 2(2):135-138.
31. Mozaffarian D, Ascherio A, Hu FB, et al.: Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation 2005, 111(2):157-164.
32. US Department of Health and Human Services Agency for Healthcare Research and Quality: Effects of omega-3 fatty acids on cardiovascular risk factors and intermediate markers of cardiovascular disease. Evidence Report/Technology Assessment (Summary): Number 93. Available at http://www.ahrq.gov/clinic/ epcsums/o3cardrisksum.htm2004. Accessed May 2010.
33. Weber PC: Clinical studies on the effects of n-3 fatty acids on cells and eicosanoids in the cardiovascular system. J Intern Med Suppl 1989, 225(731):61-68.
34. Weber PC, Leaf A: Cardiovascular effects of omega 3 fatty acids. Atherosclerosis risk factor modification by omega 3 fatty acids. World Rev Nutr Diet 1991, 66:218-232.
35. Simopoulos AP: Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999, 70 (3 Suppl): 560S-569S.
36. Ross R: Atherosclerosis-an inflammatory disease. N Engl J Med 1999, 340(2):115-126.
37. Ridker PM, Hennekens CH, Buring JE, Rifai N: C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000, 342(12):836-843.
38. Patrono C: The PGH-synthase system and isozymeselective inhibition. J Cardiovasc Pharmacol 2006, 47 (Suppl 1): S1-S6.
39. Patrono C, Falco A, Davi G: Isoprostane formation and inhibition in atherothrombosis. Curr Opin Pharmacol 2005, 5(2):198-203.
40. Needleman P, Raz A, Minkes MS, et al.: Triene prostaglandins: prostacyclin and thromboxane biosynthesis and unique biological properties. Proc Natl Acad Sci USA 1979, 76(2):944-948.
41. Engstrom K, Wallin R, Saldeen T: Effect of low-dose aspirin in combination with stable fish oil on whole blood production of eicosanoids. Prostaglandins Leukot Essent Fat Acids 2001, 64(6):291-297.
42. Kramer HJ, Stevens J, Grimminger F, Seeger W: Fish oil fatty acids and human platelets: dosedependent decrease in dienoic and increase in trienoic thromboxane generation. Biochem Pharmacol 1996, 52(8):1211-1217.
43. Calo L, Bianconi L, Colivicchi F, et al.: N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol 2005, 45(10):1723-1728.
44. Reiffel JA, McDonald A: Antiarrhythmic effects of omega-3 fatty acids. Am J Cardiol 2006, 98 (4A): 50i-60i.
45. Senges S: Randomized trial of omega-3 fatty acids on top of modern therapy after acute myocardial infarction: the OMEGA trial. Presented at the American College of Cardiology 58th Annual Scientific Session. Orlando, FL: March 29-31, 2009.
46. Tavazzi L, Maggioni AP, Marchioli R et al.: Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet 2008, 372(9645):1223-1230. The GISSI Heart Failure trial randomly assigned 6975 patients with chronic, stable heart failure on optimal medical therapy to receive omega-3 fatty acid. After a median follow-up of 3.9 years, those assigned to omega-3 fatty acid supplementation experienced a 9% relative risk reduction (ARR, 1.8%; P<0.05) in total mortality and an 8% relative risk reduction (ARR, 2.3%; P<0.01) in mortality or cardiovascular hospital admissions. This was the first omega-3 trial performed specifically in the heart failure population and led some experts to recommend omega-3 supplementation for heart failure patients
47. Brouwer IA, Raitt MH, Dullemeijer C, et al.: Effect of fish oil on ventricular tachyarrhythmia in three studies in patients with implantable cardioverter defibrillators. Eur Heart J 2009, 30(7):820-826.
48. Mozaffarian D, Rimm EB: Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006, 296(15):1885-1899.
49. Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP: Serum long-chain n-3 polyunsaturated fatty acids and risk of hospital diagnosis of atrial fibrillation in men. Circulation 2009, 120(23):2315-2321.
50. Macchia A, Varini S, Grancelli H, et al.: The rationale and design of the FORomegaARD Trial: a randomized, double-blind, placebo-controlled, independent study to test the efficacy of n-3 PUFA for the maintenance of normal sinus rhythm in patients with previous atrial fibrillation. Am Heart J 2009, 157(3):423-427.
51. Pratt CM, Reiffel JA, Ellenbogen KA, et al.: Efficacy and safety of prescription omega-3-acid ethyl esters for the prevention of recurrent symptomatic atrial fibrillation: a prospective study. Am Heart J 2009, 158(2):163-169. e161-163.
52. US Department of Health and Human Services Agency for Healthcare Research and Quality: Effects of omega-3 fatty acids on cardiovascular disease. Evidence Report/Technology Assessment: Number 94. Available at http://www.ahrq.gov/ downloads/pub/evidence/pdf/o3cardio/o3cardio.pdf. Accessed May 2010.
53. US Food and Drug Administration: Center for Food Safety and Applied Nutrition. Washington, DC: Department of Health and Human Services; 2004.
54. Watson PD, Joy PS, Nkonde C, et al.: Comparison of bleeding complications with omega-3 fatty acids + aspirin + clopidogrel-versus-aspirin + clopidogrel in patients with cardiovascular disease. Am J Cardiol 2009, 104(8):1052-1054.
55. Hites RA, Foran JA, Carpenter DO, et al.: Global assessment of organic contaminants in farmed salmon. Science 2004, 303(5655):226-229.
56. Foran SE, Flood JG, Lewandrowski KB: Measurement of mercury levels in concentrated over-the-counter fish oil preparations: is fish oil healthier than fish? Arch Pathol Lab Med 2003, 127(12):1603-1605.
57. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): 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) final report. Circulation 2002, 106(25):3143-3421.
58. Bays HE, McKenney J, Maki KC, et al.: Effects of prescription omega-3-acid ethyl esters on non-high-density lipoprotein cholesterol when coadministered with escalating doses of atorvastatin. Mayo Clin Proc 2010, 85(2):122-128.
59. Davidson MH, Stein EA, Bays HE, et al.: Efficacy and tolerability of adding prescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study. Clin Ther 2007, 29(7):1354-1367.
60. American Heart Association: Methodology Manual for ACC/AHA Guideline Writing Committees: Methodologies and Policies from the ACC/AHA Task Force on Practice Guidelines. Available at http://www.acc.org/qualityandscience/clinical/ manual/pdfs/methodology.pdf and http://circ. ahajournals.org/manual/. Accessed February 16, 2010.