Margarine containing Omega-3 Fatty Acids in Heart Attack Patients

September 6, 2010


n-3 Fatty Acids and Cardiovascular Events after Myocardial Infarction
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.

Dr. Holub's Comments:

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.

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