Impact of Omega-3 Supplementation on High Sensitive C-Reactive Protein Level and 30-Day Major Adverse Cardiac Events After the Implementation of Coronary Stent in Patients with Chronic Kidney Disease: A Randomized Clinical Study

Abstract

Purpose: Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adverse effects of percutaneous coronary intervention (PCI). In addition, the role of elevated high sensitive C-reactive protein (hs-CRP) in the prediction of adverse cardiac outcomes after coronary stent implantation has already been shown. Therefore, in this study, we aimed to evaluate the effect of omega-3 supplementation on hs-CRP and 30-day major adverse cardiac events (MACE) in patients with CKD undergoing elective PCI.Methods: In this randomized trial, 80 CKD patients who were candidates for elective PCI, were randomly assigned to two groups; the first group received a single dose of omega-3 (2500 mg, 12 h before PCI) as well as the standard drug regimen of PCI and the second group received placebo plus the standard therapy (325 mg loading dose of aspirin, 600 mg loading dose of clopidogrel, and weight-adjusted intravenous heparin). Hs-CRP levels were measured at baseline and 24 h after the intervention as a primary endpoint. The secondary endpoint was the incidence of MACE over a 30-day period after PCI.Results: Omega-3 did not significantly decrease post-PCI serum level of hs-CRP; however, the overall 30-day MACE was significantly lower in the omega-3 group compared to the control group (p=0.05).Conclusion: Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; hence, omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI. The evaluation of the effect of omega-3 on long-term MACE is recommended for future studies.

The association between estrogen receptor 2 gene polymorphism and complexity of coronary artery disease: an analysis in elective percutaneous coronary intervention patients

“…About 75% of our cases was men. The same gender distribution was found in our previous investigation in patients undergoing elective PCI [10]. According to our results, CVD risk factors such as hypertension and active smoking were more prevalent in men compared to women.…”

“…Patients who were candidates for invasive strategy with coronary angiography were enrolled into the study. Patients received Aspirin, clopidogrel, and anticoagulation according to current guidelines prior to coronary angiography (aspirin, 325 mg loading dose and then 80 mg/d for the rest of their life and clopidogrel, 600 mg loading dose and then 75 mg/d for at least one year after PCI as well as weight-adjusted intravenous heparin with a target activated clotting time of 250-350 Sec before PCI [10]. Procedure was performed with local anesthesia and via radial or femoral approaches [11].…”

Vitamin D Deficiency is Associated With Higher Level of High Sensitivity C-reactive Protein (Hs-crp) in Patients Undergoing Elective Coronary Stenting

“…Therefore, it is assumed that addition of agents capable of decreasing this in ammatory biomarker, to the standard drug regimen before PCI may be effective in the prevention of post-PCI complications. (23) There are several reports demonstrating the relationship between vitamin D and in ammation. Vitamin D de ciency has been also reported to be associated with cardiovascular in ammation (24) and vascular endothelial dysfunction.…”

Impact of supplementation with omega-3 in the prevention of contrast-induced nephropathy following elective percutaneous coronary intervention in patients with chronic kidney disease: A randomized placebo-controlled trial

“…Although the exact mechanism of omega-3 in improving renal function is still unclear, several mechanisms have been postulated including anti-inflammatory effect, reduction in the production of pro-inflammatory leukotrienes, preventing the infiltration of neutrophils into kidney tissue in the inflammatory process, preventing the release of arachidonic acid from kidney cells, increasing in the renal vasodilatory capacity, antioxidant properties, and reducing the risk for the development of end stage renal disease. [ 11 20 21 ]…”