n-3 Polyunsaturated Fatty Acids After Coronary Artery Bypass Grafting

Benedetto, Umberto; Melina, Giovanni; Bartolomeo, Roberta Di; Angeloni, Emiliano; Sansone, D; Falaschi, Giulia Maria; Capuano, Fabio; Comito, Cosimo; Roscitano, Antonino; Sinatra, Riccardo

doi:10.1016/j.athoracsur.2010.11.068

Cited by 15 publications

(12 citation statements)

References 25 publications

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“…A recent study in patients after coronary artery bypass surgery reported by Benedetto et al found that in those prescribed omega-3 fatty acids at discharge, 2.5-year mortality was reduced by almost 50% 43 . Higher plasma EPA levels (caused by 1.8 g/d EPA supplementation for 5 years) were also associated with reduced major cardiac events in the Japan EPA Lipid Intervention Study 44 .…”

Section: Discussionmentioning

confidence: 97%

Red blood cell fatty acid levels improve GRACE score prediction of 2-yr mortality in patients with myocardial infarction

Harris¹,

Kennedy²,

O’Keefe³

et al. 2013

International Journal of Cardiology

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Background Blood omega-3 and omega-6 fatty acid levels have been associated with reduced risk for total mortality in patients with stable coronary heart disease (CHD), but their relationships with mortality in the setting of myocardial infarction (MI) are unknown. Objective To determine the association between red blood cell (RBC) fatty acid levels measured at admission and 2-year mortality in MI patients, independent of the GRACE risk score, a traditional mode of risk stratification, Design Admission RBC fatty acid levels were measured in patients enrolled in a prospective, 24-center MI registry (TRIUMPH). Two-year mortality was modeled with Cox proportional hazards regression to assess the extent to which the inclusion of fatty acid levels would improve, over and above the GRACE score, risk stratification for 2-year mortality. Results RBC fatty acid data were available from 1,144 patients who did not report taking fish oil supplements after discharge. Two RBC fatty acids [eicosapentaenoic acid (EPA n-3) and docosapentaenoic n-6 (DPA)] were univariate predictors of total mortality. The combined fatty acid c-statistic (0.60, p<0.001) improved the c-statistic of the GRACE score alone from 0.747 (p<0.001) to 0.768 (p<0.05 vs. GRACE alone). The net reclassification index improved by 31% (95% CI, 15% to 48%) and the relative incremental discrimination index improved by 19.8% (7.5% to 35.7%). Conclusion RBC EPA and DPA n-6 levels improved the prediction of 2-yr mortality over and above the GRACE score in MI patients.

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Section: Discussionmentioning

confidence: 97%

Red blood cell fatty acid levels improve GRACE score prediction of 2-yr mortality in patients with myocardial infarction

Harris¹,

Kennedy²,

O’Keefe³

et al. 2013

International Journal of Cardiology

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“…The conflicting conclusions from observational studies (that have commonly observed morbidity and mortality benefits associated with higher omega-3 fatty acid intakes/levels [2–4, 27]) and RCTs (which recently have not [9]) may have several explanations. On the one hand, the RCTs may have enrolled particularly compliant patients with higher than expected background dietary intakes of omega-3 fatty acids.…”

Section: Discussionmentioning

confidence: 99%

Multiple differences between patients who initiate fish oil supplementation post–myocardial infarction and those who do not: the TRIUMPH Study

Harris

Kennedy²,

Maddox

et al. 2016

Nutrition Research

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The utility of fish oil supplements (FOS) in patients who survive an acute myocardial infarction (MI) remains controversial, with randomized trials showing less benefit than observational studies would suggest. The differences in the characteristics of MI patients who use FOS in routine clinical care are unknown, but may help explain this discrepancy. We utilized data from a 24-site registry study in which extensive information was available on 4340 MI patients at admission and 1, 6, and 12 months post discharge. After excluding those using FOS at admission (n=651), who died before the 1-month follow-up visit (n=63), and those with missing data at 1 month (n=1228), 2398 remained. Of them 377 (16%) started FOS within 1 month of their MI. We analyzed 53 patient characteristics associated with FOS use. We observed differences (p<0.001) in 20 demographic, socio-economic, treatment, disease severity and health status domains. FOS users were more likely than non-users to be white, married, financially secure, highly educated, and eating fish. They also had a higher ejection fraction at discharge, were more likely to have had in-hospital percutaneous coronary interventions and were more likely to have participated in cardiac rehabilitation programs. FOS users were less likely to have a history of diabetes, alcohol abuse, stroke, MI and angina. In conclusion, post-MI patients who initiate FOS within 1 month of discharge in routine clinical practice differ substantially from those who do not. These differences are strongly associated with a better post-MI prognosis and may illuminate several sources of unmeasured confounding in observational studies.

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“…PUFA supplementation in individuals with known CAD. 48 A large-scale (n=610), randomized controlled trial called the Shunt Occlusion Trail (SOT) 49 was one of the first efforts to investigate the effect of omega-3 PUFA supplementation in patients undergoing CABG. Patients were assigned to receive either 4 g of fish oil or to the control group, while continuing antithrombotic medications (aspirin or warfarin).…”

Section: Ventricular Arrhythmiasmentioning

confidence: 99%

Assessment of Red Blood Cell Membrane Fatty Acid Composition in Relation to Dietary Intake in Patients Undergoing Cardiac Catheterization

Litwin

Clark

Singh

et al. 2014

Journal of the Academy of Nutrition and Dietetics

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n-3 Polyunsaturated Fatty Acids After Coronary Artery Bypass Grafting

Cited by 15 publications

References 25 publications

Red blood cell fatty acid levels improve GRACE score prediction of 2-yr mortality in patients with myocardial infarction

Red blood cell fatty acid levels improve GRACE score prediction of 2-yr mortality in patients with myocardial infarction

Multiple differences between patients who initiate fish oil supplementation post–myocardial infarction and those who do not: the TRIUMPH Study

Assessment of Red Blood Cell Membrane Fatty Acid Composition in Relation to Dietary Intake in Patients Undergoing Cardiac Catheterization

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