Randomized controlled trial of gamma-linolenic acid and eicosapentaenoic acid in peripheral arterial disease

Lee, A.J.; Fowkes, F. Gerry R.; Jepson, Ruth; Lowe, G. D. O.; Skinner, E. R.; Mowat, B

doi:10.1016/s0261-5614(98)80318-x

Cited by 81 publications

(49 citation statements)

References 35 publications

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“…All were single-centre trials published between 1990 and 2010. All trials were adjudicated to be of high (3/5) [34-36] or unclear (2/5) [37,38] risk of bias (Table 3). Due to the small number of trials included, formal assessment of reporting bias (e.g., by using a funnel plot) was not possible.…”

Section: Resultsmentioning

confidence: 99%

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis

Enns

Yeganeh

Zarychanski

et al. 2014

BMC Cardiovasc Disord

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BackgroundIndividuals with peripheral arterial disease are at higher risk for cardiovascular events than the general population. While supplementation with omega-3 polyunsaturated fatty acids (PUFA) has been shown to improve vascular function, it remains unclear if supplementation decreases serious clinical outcomes. We conducted a systematic review and meta-analysis to determine whether omega-3 PUFA supplementation reduces the incidence of cardiovascular events and complications in adults with peripheral arterial disease.MethodsWe searched five electronic databases (MEDLINE, EMBASE, CENTRAL, Scopus and the International Clinical Trials Registry Platform) from inception to 6 December 2013 to identify randomized trials of omega-3 PUFA supplementation (from fish or plant oils) that lasted ≥12 weeks in adults with peripheral arterial disease. No language filters were applied. Data on trial design, population characteristics, and health outcomes were extracted. The primary outcome was major adverse cardiac events; secondary outcomes included myocardial infarction, cardiovascular death, stroke, angina, amputation, revascularization procedures, maximum and pain-free walking distance, adverse effects of the intervention, and quality of life. Trial quality was assessed using the Cochrane Risk of Bias tool.ResultsOf 741 citations reviewed, we included five trials enrolling 396 individuals. All included trials were of unclear or high risk of bias. There was no evidence of a protective association of omega-3 PUFA supplementation against major adverse cardiac events (pooled risk ratio 0.73, 95% CI 0.22 to 2.41, I 2 75%, 2 trials, 288 individuals) or other serious clinical outcomes. Adverse events and compliance were poorly reported.ConclusionsOur results showed that insufficient evidence exists to suggest a beneficial effect of omega-3 PUFA supplementation in adults with peripheral arterial disease with regard to cardiovascular events and other serious clinical outcomes.

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Section: Resultsmentioning

confidence: 99%

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis

Enns

Yeganeh

Zarychanski

et al. 2014

BMC Cardiovasc Disord

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“…Data on n-3 fatty acids, such as linolenic fatty acid, were not available in our database; other investigators have reported that low levels of n-3 fatty acid might be associated with PAD. 38 Despite the absence of a big difference in lipid profile, we still believe that fat intake may be related to PAD via abnormalities in lipid metabolism. Our quantitative determinations of lipoprotein indicated that almost the whole population (>85%) has some abnormality in their lipid profile.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequent studies have confirmed the association between levels of n-3 fatty acids and risk of coronary disease. 38 Similarly, deficiency in n-6 fatty acids also appears to be related to heart disease, and low levels of linoleic acid have been inversely related to a gradient of coronary heart disease in European countries. Our descriptive analysis indicates that subjects with PAD had significantly lower consumption of linoleic acid (11.0 g) than those without the disease (11.7 g), which is also reflected by the crude OR values (highest vs lowest quintile).…”

Section: Discussionmentioning

confidence: 99%

Fat and Fiber Consumption are Associated With Peripheral Arterial Disease in a Cross-Sectional Study of a Japanese-Brazilian Population

Gimeno

Hirai

Harima

et al. 2008

Circ J

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eripheral arterial disease (PAD) is a severe atherosclerotic complication of diabetes mellitus and hypertension with a deleterious impact on the quality of life. Walking intolerance and amputation are major problems for subjects with PAD. Moreover, this is associated with an increased cardiovascular and cerebrovascular morbidity and mortality. People with PAD are more than 4 times likely to die of any cause over 2 years from diagnosis than those without this condition. [1][2][3][4] PAD may be identified non-invasively by the determination of the ankle-to-brachial systolic blood pressure (BP) index; values <0.9 are indicative of the presence of disease. [5][6][7] Similar to other sites of the atherosclerotic disease, dyslipidemia, diabetes, hypertension and use of tobacco are major risk factors for PAD. The inflammation process contributes to the progression of the atherosclerotic lesion. Considering that underlying mechanisms of peripheral and coronary artery diseases are common, similarities in dietary risk factors for both conditions would be expected. 8 Cohort and cross-sectional studies showed a high risk of PAD among subjects with a low intake of dietary antioxidants (eg, carotenoids, and vitamins C and E) or with low circulating levels of these substances. 7,9,10 However, PAD has received less attention in nutrition research, perhaps because its non-fatal presentation becomes symptomatic at a more advanced age compared with other forms of atherosclerosis, such as coronary heart disease and stroke. 11 Epidemiological studies have detected an inverse association between fiber consumption and PAD. 3 This finding is quite plausible as soluble fiber intake was shown to reduce low-density lipoprotein (LDL)-cholesterol levels. In addition to having a favorable impact on total and LDL-cholesterol and fasting insulin, cereal fiber has been inversely associated with cardiovascular risk. The type of dietary fat consumed has been closely related to atherosclerotic diseases, including PAD. 12 The replacement of saturated fatty acids by mono-or polyunsaturated fatty acids was shown to reduce significantly total and LDL-cholesterol levels. Some evidence suggests that resistance to lipid oxidation could be improved with a diet that has a high content of antioxidants, thus improving the dietary fatty acid composition. 12 The Western diet, which is often characterized by a low content of complex carbohydrates and is rich in animal fat, plays a role in the epidemics of obesity and related diseases, which are also found in migrants from Asian countries. [13][14][15] However, we did not know whether any component of their usual diet would be associated with PAD, as diagnosed by the ankle-to-brachial systolic BP index. This cross-sectional Fat and Fiber Consumption are Associated With Peripheral Arterial Disease in a Cross-Sectional Study of a Japanese-Brazilian PopulationSuely Godoy Agostinho Gimeno, PhD; Amélia Toyomi Hirai, MD; Helena Aiko Harima, PhD; Mário Yasuo Kikuchi, PhD; Rosana Farah Simony, PhD; Newton de Barros Jr,...

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“…3 trials of fish oil supplements reported trends of increased strokes [97,140,141], while 3 diet/dietary advice trials reported trends of fewer strokes [120,142,143]. None of the results from the 6 studies was statistically significant.…”

Section: Effects On Strokementioning

confidence: 97%

Cardiovascular Effects of Omega-3 Free Fatty Acids.

Biscione¹,

Pignalberi²,

Totteri³

et al. 2007

CVP

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Omega-3 fatty acids are essential substances for the development and function of human organism. They cannot be synthesized in humans, and consequently have to be acquired from food, almost exclusively from fish. Omega-3 fatty acids exert potent anti-inflammatory and anti-atherosclerotic actions by interfering with the metabolism of arachidonic acid, modifying lipid composition (mainly lowering triglycerides), improving hemodynamics and reducing cardiac hypertrophy. Recently, clinical and experimental studies demonstrated an anti-arrhythmic effect and a significant impact on survival after myocardial infarction (MI). It follows that omega-3 fatty acids have been widely accepted for clinical use in patients with dyslipidemia or with atherosclerotic disease and in survivors of acute MI. This review briefly explores the metabolic mechanisms and the clinical effects of this class of substances and considers their use in patients with cardiovascular disease.

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Randomized controlled trial of gamma-linolenic acid and eicosapentaenoic acid in peripheral arterial disease

Cited by 81 publications

References 35 publications

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis

The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis

Fat and Fiber Consumption are Associated With Peripheral Arterial Disease in a Cross-Sectional Study of a Japanese-Brazilian Population

Cardiovascular Effects of Omega-3 Free Fatty Acids.

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