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Research: MARESTA and colleagues,
Listed in Issue 87
Abstract
MARESTA and colleagues, Department of Cardiology, Ospedale S. Maria della Croci, Ravenna, Italy, carried out a study to investigate whether long-term supplementation with omega-3 fatty acids (FA) prior to undergoing percutaneous transluminal coronary angioplasty (PTCA) might reduce the occurrence of restenosis (reblockage of coronary arteries) in the future.
Background
Some previous studies have examined whether supplementation with omega-3 FAs can reduce restenosis, but the results have been inconclusive.
Methodology
This randomized, double-blind, placebo-controlled trial enrolled 339 patients scheduled to undergo PTCA for coronary artery disease. Subjects received either: 1) 6 x 1-g capsules daily comprising 3 g eicosapentaenoic acid (EPA) and 2.1 g docosahexaenoic acid (DHA); or 2) identical capsules containing olive oil (‘placebo’). Treatment was begun 1 month prior to PTCA and continued for 1 further month after the procedure. Of the original 339 patients randomized to study treatments, 257 patients (125 in the omega-3 FA group and 132 in the placebo group) who were well matched for risk factors underwent successful balloon-only PTCA (280 total lesions) and were able to undergo evaluation at 6 months by repeat angiography. Restenosis was defined as recurrence of greater than 50% diameter blockage of the dilated artery (Definition I) and as greater than 50% loss of the short-term gain immediately after PTCA (Definition II).
Results
In the omega-3 FA group, restenosis rates were 29.4% versus 39.6% in the placebo group according to Definition I; analogous restenosis rates according to Definition II were 31.6% and 35.4% respectively (no significant difference). Restenosis rates per patient were 31.2% in the omega-3 FA group versus 40.9% in the placebo group according to Definition I; and were 33.6% and 37.1% respectively according to Definition II (no significant difference).
Conclusion
1-months’ supplementation with omega-3 FAs (EPA and DHA) prior to PTCA resulted in a small (up to 10%) but statistically significant decrease in the rate of occurrence of restenosis compared with placebo treatment.
References
Maresta A et al. Prevention of postcoronary angioplasty restenosis by omega-3 fatty acids: main results of the Esapent for Prevention of Restenosis ITalian Study (ESPRIT). American Heart Journal 143 (6): E5. Jun 2002.
