1. n-3 Fatty Acids, Ventricular Arrhythmia-Related Events, and Fatal Myocardial Infarction in Postmyocardial Infarction Patients With Diabetes
- Author
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Linda M. Oude Griep, Jaap W. Deckers, Eric Boersma, Barbara J.M. Mulder, Daan Kromhout, Erik J. Giltay, Menko-Jan de Boer, Janette de Goede, Johanna M. Geleijnse, Peter L. Zock, Amsterdam Cardiovascular Sciences, Cardiology, Epidemiology, and Hematology
- Subjects
medicine.medical_specialty ,Nutrition and Disease ,dietary-supplements ,Endocrinology, Diabetes and Metabolism ,Placebo-controlled study ,cardiovascular-disease ,Infarction ,ASG Facilities, Staff & Services ,Staff & Services ,Sudden death ,ASG Facilities ,SDG 3 - Good Health and Well-being ,placebo-controlled trial ,Voeding en Ziekte ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Myocardial infarction ,cardiovascular diseases ,omega-3-fatty-acids ,VLAG ,risk ,Global Nutrition ,Advanced and Specialized Nursing ,Wereldvoeding ,Cardiovascular diseases [NCEBP 14] ,business.industry ,Hazard ratio ,base-line characteristics ,medicine.disease ,mortality ,Eicosapentaenoic acid ,fish intake ,Surgery ,sudden-death ,Docosahexaenoic acid ,Cardiology ,coronary-heart-disease ,business - Abstract
OBJECTIVE We carried out a secondary analysis in high-risk patients with a previous myocardial infarction (MI) and diabetes in the Alpha Omega Trial. We tested the hypothesis that in these patients an increased intake of the n-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and α-linolenic acid (ALA) will reduce the incidence of ventricular arrhythmias and fatal MI. RESEARCH DESIGN AND METHODS A subgroup of 1,014 post-MI patients with diabetes aged 60–80 years was randomly allocated to receive one of four trial margarines, three with an additional amount of n-3 fatty acids and one placebo for 40 months. The end points were ventricular arrhythmia–related events and fatal MI. The data were analyzed according to the intention-to-treat principle, using multivariable Cox proportional hazards models. RESULTS The patients consumed on average 18.6 g of margarine per day, which resulted in an additional intake of 223 mg EPA plus 149 mg DHA and/or 1.9 g ALA in the active treatment groups. During follow-up, 29 patients developed a ventricular arrhythmia–related events and 27 had a fatal MI. Compared with placebo patients, the EPA-DHA plus ALA group experienced less ventricular arrhythmia–related events (hazard ratio 0.16; 95% CI 0.04–0.69). These n-3 fatty acids also reduced the combined end-point ventricular arrhythmia–related events and fatal MI (0.28; 0.11–0.71). CONCLUSIONS Our results suggest that low-dose supplementation of n-3 fatty acids exerts a protective effect against ventricular arrhythmia–related events in post-MI patients with diabetes.
- Published
- 2011