Abstract 16294: Omega-3 Fatty Acid Added to Statin Prevents Progression of Fibrous Coronary Artery Plaque Compared to Statin Alone in Patients With Coronary Artery Disease
Introduction: In the Japan Eicosapentaenoic acid (EPA) Lipid Intervention Study, 1.8 g of the omega-3 fatty acid (FA), EPA, added to a statin reduced major coronary events by 19% (p=0.011) compared to statin alone. The effect of omega-3 FAs on progression of coronary plaque volume is not clear.
Hypothesis: High dose omega-3 FA added to maximal statin treatment reduces progression of coronary artery plaque compared to statin alone.
Methods: 219 subjects with stable CAD were randomized to either 3.6 g of omega-3 FAs (1.86 g of EPA and 1.5 g of docosahexaenoic acid) per day or no omega-3 FAs (termed control) for 30 months. All received statin and aspirin. Using coronary computed tomographic angiography, we measured the indexed plaque volume (plaque volume [mm3] divided by segment length in mm) of fatty, fibrous, non-calcified, calcified and total plaque at baseline and 30-month follow-up. Segments with significant calcification imparting “calcium-bloom” artifact, ≤ 5mm in length and prior revascularization were excluded.
Results: Mean age was 62.5 ± 7.6 years (SD) (14% women). Mean low density lipoprotein cholesterol (LDL-C) was similar between the two groups: 77.8 ± 28.3 vs. 80.4 ± 34.2 mg/dL, p=0.56. Triglyceride levels were reduced 16.4% in the omega-3FA group compared to 1.7% (p=0.003) in controls; no other significant differences were noted. Subjects receiving omega-3 FAs had significantly less progression of fibrous plaque volume compared to subjects not receiving omega-3 FAs - median % change = 0.55% vs. 5.0%; p=0.033, respectively. However, there was no significant difference between omega-3 FA and control groups in the percent change of fatty, non-calcified, calcified or total indexed plaque volumes (Table).
Conclusions: High-dose omega-3 FAs provided additional benefit to maximal statin treatment in preventing progression of fibrous coronary plaque volume over 30 months compared to a statin alone in the setting of well-controlled LDL-C levels.
Author Disclosures: A. Alfaddagh: None. T. Elajami: None. F. Welty: None.
- © 2016 by American Heart Association, Inc.