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Omega-3s of No Added Benefit to Heart Attack Patients

Standard therapy wipes out any protection the supplement might provide, study finds,,

MONDAY, March 30 (HealthDay News) -- Patients receiving optimal drug therapy after suffering a heart attack do not gain any additional benefit from taking supplemental omega-3 fatty acids, a new study finds.

In a study of almost 4,000 people who suffered heart attacks, researchers found no difference in rates of heart attack, stroke, sudden cardiac death or death from any cause regardless of whether they were taking the supplements or not. This finding contradicts previous studies, which suggested that taking omega-3 fatty acids improved long-term survival.

"Although omega-3 fatty acids are considered effective for improving prognosis after acute myocardial infarction, no randomized, double-blind trial has tested their effect on top of current, strictly guideline-based treatment," Dr. Jochen Senges, a professor of cardiology at the Heart Center Ludwigshafen at the University of Heidelberg in Germany, said in a prepared statement.

"In our study, we saw no beneficial effect. In patients who are already taking optimal medical therapy, cardiac event rates become very low, and omega-3 do not further improve them," he said.

The findings of the study were to be presented Monday at the American College of Cardiology's annual meeting, in Orlando, Fla.

For the study, Senge's team randomly assigned more than 3,800 patients who participated in the trial to treatment with highly purified omega-3 fatty acid supplements or placebo. In addition, patients received optimal medical care.

At the time of their heart attack, almost 78 percent of the patients underwent angioplasty to open the blocked coronary artery. Other patients (8 percent) received clot-busting drugs.

Upon discharge from the hospital, most patients were prescribed drugs known to reduce the risk of having another heart attack. Almost 94 percent of the patients were prescribed beta-blockers, 83 percent got ACE inhibitors, 95 percent took aspirin, 94 percent got a statin, and 88 percent received the anti-clotting drug clopidogrel (best known as Plavix), according to the report.

Over a little more than a year, 4.1 percent of the patients died, 3.9 percent suffered another heart attack, 1.7 percent had a non-lethal stoke, and 1.5 percent suffered sudden cardiac death.

There were no differences in these outcomes for patients receiving omega-3 fatty acid supplements or the placebo, Senges' group found.

Other studies have shown that omega-3 fatty acids do appear to help prevent heart attacks. Omega-3 fatty acids are found naturally in oily fish such as mackerel or salmon.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, noted that the benefits of omega-3 fatty acids for people who have suffered a heart attack has been demonstrated in other trials.

"Prior trials have shown a modest benefit of omega-3 fatty acid supplementation after [heart attack]," Fonarow said. "To demonstrate this modest benefit, in the previous GISSI-Prevention trial, over 11,000 patients were enrolled and followed many years," he said.

"With the smaller number of subjects [in the new trial] who were at lower risk of recurrent events, no incremental benefit could be demonstrated -- potentially due to the study being substantially underpowered to detect modest benefit," Fonarow said.

So, in his opinion, "the balance of data would still support omega-3 fatty acid supplementation, along with other guideline-recommended therapies and lifestyle modification, for patients with and at risk for cardiovascular disease."

More information

For more about omega-3 fatty acids, visit the American Heart Association.

SOURCES: Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; March 30, 2009, news release, American College of Cardiology; March 30, 2009, presentation, i2 Summit at the American College of Cardiology's 58th annual scientific session, Orlando, Fla.

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