American
College of Cardiology’s 58th Annual Scientific Sessions
Supplementation with omega-3 fatty acids on top of current optimized
medical treatment did not further improve CV outcomes among patients with
recent MI, according to findings from the OMEGA-Trial presented at the American
College of Cardiology’s 58th Annual Scientific Sessions.
Sudden cardiac death rate improved after one year, but was the same
— 1.5% — among patients taking omega-3 acid ethylesters 90 (1 g
daily) and those taking placebo.
OMEGA-Trial data contradict that of previous studies, which have
suggested that omega-3 fatty acid supplementation improves prognosis and
long-term survival after acute MI.
The 3,827 patients (mean age, 64 years; 74.4% men) randomized to omega-3
fatty acids or placebo were included in the trial three to 14 days after having
an MI.
Jochen Senges, MD, emphasized that omega-3 fatty acid
supplementation was given in conjunction to guidelines-based optimal medical
care.
“It’s difficult to [get better results] than this, and omega-3
fatty acids for one year does not improve the rate of sudden cardiac death or
secondary endpoints,” said Senges, professor of cardiology at the Heart
Center Ludwigshafen, University of Heidelberg, Germany. “It would be
incorrect to say that omega-3 fatty acids are not effective, but we could not
find any additional benefits after optimizing medical therapy,” he said.
OMEGA researchers reported no significant between-group differences in
secondary endpoints, including total death reinfarction, stroke, arrhythmic
events and composite total death, reinfarction and stroke.
A slight difference was noted with overall triglyceride levels (omega-3
fatty acids, 121 mg/dL; placebo, 127 mg/dL) and percentage of patients with
triglycerides <150 mg/dL (34.5% vs. 38.1%).
Acute treatment and at-hospital discharge were “very strict,”
according to Senges, including 95.3% of patients prescribed aspirin and 94.1%
beta blockers upon discharge. Almost 94% of patients had coronary angiography
at the time of MI, and 77.8% underwent percutaneous coronary intervention.
Senges noted one study limitation: the calculated sample size was too
small for the calculated power of 80% (realized power: 50%). – by Katie
Kalvaitis
This is a patient population that had MI but the most aggressive form of
therapy, primary coronary intervention to open coronary arteries. This is a
super well-treated population with clearly no effect [of omega-3 fatty acids]
given the background information and therapy delivered. If followed for three
years or four years, [I wonder if] the results would be the same.
– Hani N. Sabbah, PhD
Director, Cardiovascular Research Laboratories
Henry
Ford Health System
For more information:
- Senges J. Randomized trial of omega-3 fatty acids on top of modern
therapy after acute MI: the OMEGA-Trial. #411. Presented at: American College
of Cardiology’s 58th Annual Scientific Sessions; March 29-31, 2009; Orlando, Fla.
