Margarine containing Omega-3 Fatty Acids in Heart Attack Patients
Kromhout,D. et al., New England J. Med., in press, 2010
Division of Human Nutrition, Wageningen Univ., Wageningen, The Netherlands
The Alpha Omega Trial was a double-blind , placebo-controlled trial wherein 4837 patients (avg. age of 69 years , 78 % males) who had survived a myocardial infarction and were on medical therapy were assigned to one of four different margarine groups. These margarines either contained no omega-3 fatty acids (placebo) or 2 grams LNA (alpha-linolenic acid) or 400 mg (DHA plus EPA) or 2 grams LNA plus 400 mg (DHA plus EPA). For up to 40 months thereafter, the primary end point consisting of major cardiovascular events ( fatal and non-fatal cardiovascular events and cardiac interventions) was measured.
During follow-up, 671 patients (13.9 %) experienced a major cardiovascular event. The low-dose supplementation of (DHA plus EPA) or LNA was found not to significantly reduce the rate of cardiovascular events among patients who had experienced a myocardial infarction and were receiving appropriate anti-hypertensive, anti-thrombotic, and blood lipid-lowering therapy.
Analysis of outcomes in the diabetic patients indicated that the rates of fatal coronary heart disease were significantly lower (8.7 % versus 17.1 %) for those receiving (DHA plus EPA) as compared to those on placebo or LNA only.
It is noted that the earlier GISSI study which found a 45 % reduction in sudden cardiac death for those patients (post-myocardial infarction) receiving supplemental DHA/EPA employed a daily dose of approximately 900 mg/day or over twice the intake used in this recent trial. Furthermore, the JELIS trial from Japan which showed a significant reduction in cardiovascular events in patients receiving blood cholesterol-lowering treatment (via statins) were given EPA omega-3 at a dose of 1800 mg/day over and above their expected background dietary intake of (EPA plus DHA) of approximately 1000 mg/day.