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Circulation, Vol 90, 2248-2257, Copyright © 1994 by American Heart Association
A Leaf, MB Jorgensen, AK Jacobs, G Cote, DA Schoenfeld, J Scheer, BH Weiner, JD Slack, MA Kellett and AE Raizner
BACKGROUND--The omega-3 polyunsaturated fatty acids derived from fish oils
have been shown to modulate many factors believed to affect the
pathogenesis of atherosclerosis. Because certain features of restenosis
following angioplasty mimic some of the early changes of atherogenesis,
some researchers have suggested that fish oil might prevent restenosis
following angioplasty. We report the effects of omega-3 fatty acids on the
rate of restenosis following percutaneous intraluminal coronary angioplasty
(PTCA). METHODS AND RESULTS--From August 1989 through September 1992, 551
patients were randomized to start receiving a daily dietary supplement of
ten 1.0-g capsules containing 80.6% ethyl esters of omega-3 fatty acids
providing 4.1 g eicosapentaenoic acid (EPA) and 2.8 g docosahexaenoic acid
(DHA) for 6 months or an equal amount of an ethyl ester of corn oil. Four
hundred seventy subjects who were well matched for risk factors completed
successful angioplasty of one or multiple lesions in native coronary
vessels and constituted the study cohort, of whom 447 were evaluable at 6
months after PTCA. The criteria for restenosis were that the quantitative
coronary angiography at 6 months show a > 30% increase in narrowing at
the stenosis site or loss of at least half of the gain achieved at the time
of PTCA and final restenosis with < 50% luminal diameter remaining. In
93% of the patients, the end point was determined by angiography and in all
except 1% of these by quantitative coronary angiography. Compliance with
the fish oil supplement was good as judged by incorporation of EPA and DHA
in plasma and red blood cell phospholipids. The restenosis rate among
analyzable patients was 46% for corn oil and 52% for fish oil (P = .37).
The addition of 200 mg alpha-tocopherol for all subjects during the study
had no effect on restenosis rates. CONCLUSIONS--This was the largest of
such trials to date, and a supplement of 8 g/d of omega-3 fatty acids
failed to prevent the usual high rate of restenosis after PTCA. No adverse
effects were attributable to this large daily supplement of omega-3 fatty
acids.
ARTICLES
Do fish oils prevent restenosis after coronary angioplasty?
Massachusetts General Hospital, Charlestown 02129.
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|
|
|
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References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]
|
|
|
|
|
|
P. M. Kris-Etherton, W. S. Harris, L. J. Appel, and for the Nutrition Committee Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease Circulation, November 19, 2002; 106(21): 2747 - 2757. [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Harper and T. A. Jacobson The Fats of Life: The Role of Omega-3 Fatty Acids in the Prevention of Coronary Heart Disease Arch Intern Med, October 8, 2001; 161(18): 2185 - 2192. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Crone, G. Gabriel, and T. N. Wise Non-Herbal Nutritional Supplements--The Next Wave: A Comprehensive Review of Risks and Benefits for the C-L Psychiatrist Psychosomatics, August 1, 2001; 42(4): 285 - 299. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]
|
|
|
|
 |
|
 A.P. Simopoulos Evolutionary aspects of diet, essential fatty acids and cardiovascular disease Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D8 - D21. [Abstract] [PDF]
|
|
|
|
 |
|
 J. J. Popma, E. M. Ohman, J. Weitz, A. M. Lincoff, R. A. Harrington, and P. Berger Antithrombotic Therapy in Patients Undergoing Percutaneous Coronary Intervention Chest, January 1, 2001; 119 (2009): 321S - 336S. [Full Text] [PDF]
|
|
|
|
|
|
C. von Schacky n-3 Fatty acids and the prevention of coronary atherosclerosis1 Am. J. Clinical Nutrition, January 1, 2000; 71(1): 224S - 227S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Faggin, M. Puato, A. Chiavegato, R. Franch, P. Pauletto, and S. Sartore Fish Oil Supplementation Prevents Neointima Formation in Nonhypercholesterolemic Balloon-Injured Rabbit Carotid Artery by Reducing Medial and Adventitial Cell Activation Arterioscler Thromb Vasc Biol, January 1, 2000; 20(1): 152 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Maixent, A. Gerbi, O. Barbey, C. Lan, I. Jamme, H. Burnet, A. Nouvelot, S. Levy, P. J. Cozzone, and M. Bernard Dietary fish oil promotes positive inotropy of ouabain in the rat heart Am J Physiol Heart Circ Physiol, December 1, 1999; 277(6): H2290 - H2297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P Simopoulos Essential fatty acids in health and chronic disease Am. J. Clinical Nutrition, September 1, 1999; 70(3): 560S - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. E. Billman, J. X. Kang, and A. Leaf Prevention of Sudden Cardiac Death by Dietary Pure {omega}-3 Polyunsaturated Fatty Acids in Dogs Circulation, May 11, 1999; 99(18): 2452 - 2457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Johansen, M. Brekke, I. Seljeflot, M. Abdelnoor, and H. Arnesen n-3 fatty acids do not prevent restenosis after coronary angioplasty: results from the CART study J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1619 - 1626. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. von Schacky, P. Angerer, W. Kothny, K. Theisen, and H. Mudra The Effect of Dietary {omega}-3 Fatty Acids on Coronary Atherosclerosis: A Randomized, Double-Blind, Placebo-Controlled Trial Ann Intern Med, April 6, 1999; 130(7): 554 - 562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. B. Sanders, F. R. Oakley, G. J. Miller, K. A. Mitropoulos, D. Crook, and M. F. Oliver Influence of n-6 versus n-3 Polyunsaturated Fatty Acids in Diets Low in Saturated Fatty Acids on Plasma Lipoproteins and Hemostatic Factors Arterioscler Thromb Vasc Biol, December 1, 1997; 17(12): 3449 - 3460. [Abstract] [Full Text]
|
|
|
|
|
|
P. Mata, O. Varela, R. Alonso, C. Lahoz, M. de Oya, and L. Badimon Monounsaturated and Polyunsaturated n-6 Fatty Acid–Enriched Diets Modify LDL Oxidation and Decrease Human Coronary Smooth Muscle Cell DNA Synthesis Arterioscler Thromb Vasc Biol, October 1, 1997; 17(10): 2088 - 2095. [Abstract] [Full Text]
|
|
|
|
|
|
E. J. Topol, J. J. Ferguson, H. F. Weisman, J. E. Tcheng, S. G. Ellis, N. S. Kleiman, R. J. Ivanhoe, A. L. Wang, D. P. Miller, K. M. Anderson, et al. Long-term Protection From Myocardial Ischemic Events in a Randomized Trial of Brief Integrin {beta}3 Blockade With Percutaneous Coronary Intervention JAMA, August 13, 1997; 278(6): 479 - 484. [Abstract] [PDF]
|
|
|
|
|
|
S. S. D. Nair, J. W. Leitch, J. Falconer, and M. L. Garg Prevention of Cardiac Arrhythmia by Dietary (n-3) Polyunsaturated Fatty Acids and Their Mechanism of Action J. Nutr., March 1, 1997; 127(3): 383 - 393. [Abstract] [Full Text]
|
|
|
|
|
|
N. J. Stone Fish Consumption, Fish Oil, Lipids, and Coronary Heart Disease Circulation, November 1, 1996; 94(9): 2337 - 2340. [Full Text]
|
|
|
|
|
|
J. A. Cairns, J. Gill, B. Morton, R. Roberts, M. Gent, J. Hirsh, D. Holder, K. Finnie, J. F. Marquis, S. Naqvi, et al. Fish Oils and Low-Molecular-Weight Heparin for the Reduction of Restenosis After Percutaneous Transluminal Coronary Angioplasty: The EMPAR Study Circulation, October 1, 1996; 94(7): 1553 - 1560. [Abstract] [Full Text]
|
|
|
|
|
|
B. L. Rodriguez, D. S. Sharp, R. D. Abbott, C. M. Burchfiel, K. Masaki, P.-H. Chyou, B. Huang, K. Yano, and J. D. Curb Fish Intake May Limit the Increase in Risk of Coronary Heart Disease Morbidity and Mortality Among Heavy Smokers: The Honolulu Heart Program Circulation, September 1, 1996; 94(5): 952 - 956. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. B. Katan Fish and Heart Disease N. Engl. J. Med., April 13, 1995; 332(15): 1024 - 1025. [Full Text]
|
|