Effect of eicosapentaenoic acid on restenosis rate, clinical course and blood lipids in patients after percutaneous transluminal coronary angioplasty

Abstract

In order to study the effects of eicosapentaenoic acid (Maxepa), Maxepa placebo and aspirin/dipyridamole combination on the clinical course and restenosis rate of atherosclerotic lesions after percutaneous transluminal coronary angioplasty 79 men and 29 women were randomly divided into three treatment groups and restudied angiographically within one year of the procedure. Angina recurred less in the Maxepa group than in the other groups, although not statistically so. Restenosis rate was significantly reduced in the Maxepa group (11%) compared to the placebo group (30%) but, while less, was not significantly lower than in the aspirin/dipyridamole group (17%). Maxepa treatment appears to reduce restenosis rate of coronary artery lesions after percutaneous transluminal coronary angioplasty and may be an acceptable and equally effective alternative therapy to aspirin/dipyridamole.

A prospective, randomized, and double‐blind trial on the effect of fish oil on the incidence of restenosis following ptca

“…In the present study, the daily supplementation averaged 3.15 g omega-3 fatty acids, which is within the treatment range of several previous studies [18,20,24,26]. This study regimen with nine capsules per day represents an upper limit most patients will ingest aside from his or her co-medication; however, in studies of Dehmer et al [17], Reis et al [25], and Barati et al [21] higher doses of omega-3 fatty acids (5.4, 6.0, and 4.5 g, respectively) were used.…”

“…To date, several trials have been conducted to study the effect of dietary omega-3 fatty acids supplementation on coronary restenosis [17][18][19][20][21]; of eight reported studies five showed a significant reduction in the rate of restenosis [17][18][19][20][21]; however, only two of these positive studies were randomized and placebo-controlled trials [ 18,211. Critical review of these studies reveals several limitations such as insufficient patient numbers [ 17,18,24,263 or determination of restenosis by clinical judgement [19,20]; furthermore, a complete and sufficient compliance control was conducted in two studies only [17,24] despite the fact that patients were urged to take more than 20-30 capsules per day, making compliance a crucial point of these studies.…”

Fish oil and the prevention and regression of atherosclerosis

“…Pretreatment with fish oil appears relevant as it takes weeks for the ingested 20:5n-3 and 22:6n-3 to be incorporated into the cell membranes and platelet deposition with subsequent local release of growth factors occurs very early after balloon injury of a vessel. Of the five studies without pretreatment two are negative [88,92], two [86,91] are positive and one [90] is positive based on clinical restenosis rate but negative when assessed by subsequent selective coronary angiography. On the other hand, two studies [89,94] are -3); FO, fish oil-treated group of patients; control, control group; none vessel disease; bmultivessel disease; ¢based on "intention to treat" principle; d%lesions/%lesions; e17% in aspirin/dipyridamole-treated patients.…”

“…Angiography seems to be the most appropriate approach as restenosis is observed angiographically in 11-33% of patients without symptoms or with the negative exercise tests [95]. Coronary angiography was conducted in almost all patients in four studies [87,88,91,93] and selectively in four [89,90,92,94], while in the study by Slack et al [86] only exercise tests were evaluated. O'Connor and colleagues have recently performed a meta-analysis of seven [86][87][88][89][90][91]94] studies (see also Table 6) [96] and concluded that fish oil yields a small to moderate reduction in restenosis rate (6-46%).…”

“…Table 6 contains all restenosis studies [86][87][88][89][90][91][92][93][94] with fish oil published in the English literature. With the exception of the study by Bowles et al [92] all studies include a control group.…”