The Mechanism of Action of Omega-3 Fatty Acids in Secondary Prevention Post-Myocardial Infarction

Nigel Harrison; Brihad Abhyankar

Disclosures

Curr Med Res Opin. 2005;21(1):95-100. 

In This Article

Abstract and Introduction

Abstract

Background: Omega-3 fatty acids from fish and fish oils can protect against coronary heart disease (CHD), which is still the most common cause of death in the Western economies. Evidence from epidemiological and case cohort studies indicate that consumption of fatty fish and omega-3 fatty acids reduces the risk of cardiovascular mortality.
Objective: This article briefly reviews the evidence regarding omega-3 fatty acids and CHD and outlines the mechanisms through which omega-3 fatty acids might confer cardiac benefits over and above the standard secondary prevention strategies.
Conclusion: The conclusion reached is that omega-3 fatty acids play a significant role in secondary prevention post-myocardial infarction. The mechanisms through which two of these omega-3 fatty acids, eicosapentaenoic acid and docosahexanoic acid, exert their action appear to be distinct and adjuvant to the available standard secondary prevention therapies. The role to be played by the administration of a newly licensed 90% concentrate EPA + DHA formulation (1 g/day capsule: Omacor*) is explored.

Introduction

Important medical discoveries often stem from epidemiological observations. Arctic explorers made one such observation, that despite consumption of a very rich, high fat diet, Eskimos very rarely suffered death due to coronary heart disease (CHD). The reason for this remained a mystery until two Danish scientists, Bang and Dyberg[1] looked closely at coronary artery disease mortality statistics in Greenland Eskimos and in Danish persons living in Greenland, people who had very different lifestyles. Very few cardiac deaths occurred in the Eskimos, compared to many cardiac deaths in the Danes. The answer to this mystery was in the two groups' very different diets.

It was found that their marine-based diet was very rich in omega-3 polyunsaturated fatty acids (n-3 PUFAs). These have antiarrhythmic, endothelial protective, antiatherogenic, antithrombotic and antiplatelet effects in many observational studies, which have pointed to their potential role in secondary prevention post myocardial infarction (MI).

The GISSI-Prevenzione trial[2] studied the effect of a highly purified omega-3 fatty acid supplement and found it conferred a 20% relative risk reduction in mortality and a 45% reduction in the risk of sudden cardiac death. This early protection supports the antiarrhythmic potential of omega-3 fatty acids.

A supplement containing 90% concentrate of the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosa hexanoic acid (DHA) (Omacor), has been recently licensed in the UK as adjuvant treatment in secondary prevention post-MI, in addition to standard medical treatment.

This article briefly reviews the evidence regarding omega-3 fatty acids and CHD and outlines the mechanisms through which omega-3 fatty acids might confer cardiac benefits over and above the standard secondary prevention strategies. In particular, it explores the role that the administration of a 1 g/day capsule of the licensed formulation may have to play.

*Omacor is a trade name of Pronova Biocare, Norway

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....