How Are n-3 LCPUFAs Antiarrhythmic? A Reassessment of n-3 LCPUFAs in Cardiac Disease

Table 1

Randomized controlled trials of n-3 LCPUFAs in CVD.

Study	Subjects	Intervention	Followup	Effect of n-3 LCPUFAs	Rn	Pl	Bl
DART Burr et al. [6]	2033 post-MI men	fish diet	2 years	↓ total mortality (29%); ↔ reinfarction, IHD death
GISSI Marchioli et al. [8]	11323 post-MI	1.0 g/day n-3 LCPUFAs	1 year	↓ total mortality (RR 0.59), SCD (RR 0.47)	X		X
Alpha-Omega Kromhout et al. [11]	4837 post-MI	0.4 g/day n-3 LCPUFAs	3.5 years	↔ rate of major cardiovascular event (RR 1.01)	X	X	X
OMEGA Rauch et al. [12]	3851 post-MI	1.0 g/day n-3 LCPUFAs	1 year	↔ SCD (OR 0.95), total mortality (OR 1.25)	X	X	X
SOFA; Brouwer [18]	546 ICD	2.0 g/day FO	1 year	↔ ICD intervention for VF/VT, all cause mortality (RR 0.86)	X	X	X
Leaf et al. [53]	402 ICD	2.6 g/day n-3 LCPUFAs	1 year	↔ ICD intervention for VF/VT (RR 0.72)	X	X	X
Brouwer et al. [13]	200 ICD	1.3 g/day n-3 LCPUFAs	0-2 years	↔ ICD intervention for VF/VT (RR 1.26)	X	X	X
Kowey et al. [15]	663 AF without structural heart disease	4–8 g/day n-3 LCPUFAs	0.5 years	↔ AF recurrence (HR 1.22)	X	X	X
GISSI-HF Tavazzi et al. [33]	7000 NYHA II–IV	1.0 g/day n-3 LCPUFAs	4 years	↓ time to death or hospital admission for cardiovascular reason (RR 0.92), total mortality (RR 0.91)	X	X	X
Nodari et al. [34]	133 NYHA I-II	1.0 g/day n-3 LCPUFAs	1 year	↑ LV ejection fraction (10%); ↓ NHYA classification	X	X	X
Heidarsdottir et al. [44]	168 CABG/valve repair	1.2 g/day EPA + 1.0 g/day DHA	To discharge	↔ POAF	X	X	X
Calò et al. [40]	160 CABG	2.0 g/day n-3 LCPUFAs	To discharge	↓ POAF (15% versus 33% for controls); ↓ hospital stay; ↔ all cause mortality	X		X
Saravanan et al. [5, 42]	108 CABG	2.0 g/day n-3 LCPUFAs	To discharge	↔ POAF	X	X	X
Heidt et al. [45]	102 CABG	100 mg/kg FO	To discharge	↓ POAF (17% versus 31% for controls)	X	X	X
Farquharson et al.[43]	194 CABG/valve repair	4.6 g/day n-3 LCPUFAs	To discharge	↔ POAF; ↓ length of stay in ICU	X	X	X
JELIS Yokoyama et al. [50]	18645 hypercholesterolemic	1.8 g/day EPA	5 years	18% ↓ major coronary events; ↓ unstable angina, nonfatal coronary events	X	X	X
OPERA Mozaffarian ongoing	~1500 open cardiac surgery	10 g/day n-3 LCPUFAs pre-op, 2 g/day n-3 LCPUFAs post-op	To discharge	Primary completion estimated May 2012	X	X	X

MI: myocardial infarction, ICD: implantable cardioverter defibrillator, AF: atrial fibrillation, NYHA: New York Heart Association, LV: left ventricle, CABG: coronary artery bypass graft, FO: fish oils, EPA: eicosapentaenoic acid, DHA: docosahexaenoic acid, IHD: ischemic heart disease, RR: relative risk, SCD: sudden cardiac death, OR: odds ratio, VF: ventricular fibrillation, VT: ventricular tachycardia, HR: hazard ratio, POAF: postoperative, ICU: intensive care unit, Rn: randomized, Pl: placebo controlled, Bl: blinded.