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6 April 1999 | Volume 130 Issue 7 | Pages 554-562
Background: Epidemiologic studies, studies of mechanisms of action, and many animal studies indicate that dietary intake of
Objective: To determine the effect of dietary intake of
Design: Randomized, double-blind, placebo-controlled, clinically controlled trial.
Setting: University preventive cardiology unit.
Patients: 223 patients with angiographically proven coronary artery disease.
Intervention: Fish oil concentrate (55% eicosapentaenoic and docosahexaenoic acids) or a placebo with a fatty acid composition resembling that of the average European diet, 6 g/d for 3 months and then 3 g/d for 21 months.
Measurements: The results of standardized coronary angiography, done before and after 2 years of treatment, were evaluated by an expert panel (primary end point) and by quantitative coronary angiography. Patients were followed for clinical and laboratory status.
Results: Pairs of angiograms (one taken at baseline and one taken at 2 years) were evaluated for 80 of 112 placebo recipients and 82 of 111 fish oil recipients. At the end of treatment, 48 coronary segments in the placebo group showed changes (36 showed mild progression, 5 showed moderate progression, and 7 showed mild regression) and 55 coronary segments in the fish oil group showed changes (35 showed mild progression, 4 showed moderate progression, 14 showed mild regression, and 2 showed moderate regression) (P = 0.041). Loss in minimal luminal diameter, as assessed by quantitative coronary angiography, was somewhat less in the fish oil group (P > 0.1). Fish oil recipients had fewer cardiovascular events (P = 0.10); other clinical variables did not differ between the study groups. Low-density lipoprotein cholesterol levels tended to be greater in the fish oil group.
Conclusion: Dietary intake of
Author and Article Information
From the University of Munich, Munich, Germany.
Acknowledgments: The authors thank Th. von Arnim, MD, for helpful discussions during study planning; J. Hasford, MD (Biometrisches Institut für Therapiestudien, Munich, Germany) for statistical and biometrical support; and S. Dacian, MD, for serving as an expert in the expert panel sessions. They also thank all of the study patients for their participation and all physicians involved in clinical care for their cooperation.
Grant Support: In part by the Bundesministerium für Forschung und Technologie, Germany, through Gesellschaft für Strahlenforschung (GSF, 07ERG03) and Deutsche Forschungsanstalt für Luft- und Raumfahrt (DLR, 01 EA 9501/7); Wilhelm Sander-Stiftung (93.032); Fundacion Federico; and the Deutsche Forschungsgemeinschaft (Scha 398). Pronova, A.S., Lysaker, Norway, provided the capsules and funds for monitoring.
Requests for Reprints: Clemens von Schacky, MD, Medizinische Klinik, Klinikum Innenstadt, Universität München, Ziemssenstrasse 1, D-80336 München, Germany; e-mail, vonschacky{at}medinn.med.uni-muenchen.de.
Current Author Addresses: Drs. von Schacky, Angerer, Kothny, Theisen, and Mudra: Medizinische Klinik, Klinikum Innenstadt, Universität München, Ziemssenstrasse 1, D-80336 München, Germany. ARTICLE
The Effect of Dietary
-3 Fatty Acids on Coronary Atherosclerosis
A Randomized, Double-Blind, Placebo-Controlled Trial
-3 fatty acids has antiatherosclerotic potential. Few trials in humans have examined this potential. -3 fatty acids on the course of coronary artery atherosclerosis in humans. -3 fatty acids modestly mitigates the course of coronary atherosclerosis in humans.
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|
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|
|
|
|
 |
|
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|
|
|
|
|
|
References Circulation, December 17, 2002; 106(25): 3373 - 3421. [Full Text]
|
|
|
|
|
|
P. M. Kris-Etherton, W. S. Harris, L. J. Appel, and for the Nutrition Committee Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease Circulation, November 19, 2002; 106(21): 2747 - 2757. [Full Text] [PDF]
|
|
|
|
 |
|
 K. Mayer, M. Merfels, M. Muhly-Reinholz, S. Gokorsch, S. Rosseau, J. Lohmeyer, N. Schwarzer, M. Krull, N. Suttorp, F. Grimminger, et al. omega -3 Fatty acids suppress monocyte adhesion to human endothelial cells: role of endothelial PAF generation Am J Physiol Heart Circ Physiol, August 1, 2002; 283(2): H811 - H818. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Marchioli, F. Barzi, E. Bomba, C. Chieffo, D. Di Gregorio, R. Di Mascio, M. G. Franzosi, E. Geraci, G. Levantesi, A. P. Maggioni, et al. Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione Circulation, April 23, 2002; 105(16): 1897 - 1903. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Angerer, W. Kothny, S. Stork, and C. von Schacky Effect of dietary supplementation with {omega}-3 fatty acids on progression of atherosclerosis in carotid arteries Cardiovasc Res, April 1, 2002; 54(1): 183 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Holub Clinical nutrition: 4. Omega-3 fatty acids in cardiovascular care Can. Med. Assoc. J., March 1, 2002; 166(5): 608 - 615. [Full Text] [PDF]
|
|
|
|
|
|
S. Stork, K. Baumann, C. von Schacky, and P. Angerer The effect of 17{beta}-estradiol on MCP-1 serum levels in postmenopausal women Cardiovasc Res, February 15, 2002; 53(3): 642 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Dewailly, C. Blanchet, S. Gingras, S. Lemieux, L. Sauve, J. Bergeron, and B. J. Holub Relations between n-3 fatty acid status and cardiovascular disease risk factors among Quebecers Am. J. Clinical Nutrition, November 1, 2001; 74(5): 603 - 611. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Harper and T. A. Jacobson The Fats of Life: The Role of Omega-3 Fatty Acids in the Prevention of Coronary Heart Disease Arch Intern Med, October 8, 2001; 161(18): 2185 - 2192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. B.Y. Chan, M. Man-Son-Hing, F. J. Molnar, and A. Laupacis How well is the clinical importance of study results reported? An assessment of randomized controlled trials Can. Med. Assoc. J., October 1, 2001; 165(9): 1197 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Crone, G. Gabriel, and T. N. Wise Non-Herbal Nutritional Supplements--The Next Wave: A Comprehensive Review of Risks and Benefits for the C-L Psychiatrist Psychosomatics, August 1, 2001; 42(4): 285 - 299. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A.P. Simopoulos Evolutionary aspects of diet, essential fatty acids and cardiovascular disease Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D8 - D21. [Abstract] [PDF]
|
|
|
|
|
|
Y.-Y. Fan, K. S. Ramos, and R. S. Chapkin Dietary {{gamma}}-Linolenic Acid Suppresses Aortic Smooth Muscle Cell Proliferation and Modifies Atherosclerotic Lesions in Apolipoprotein E Knockout Mice J. Nutr., June 1, 2001; 131(6): 1675 - 1681. [Abstract] [Full Text]
|
|
|
|
|
|
C. von Schacky Dietary omega-3 fatty acids and human growth factor and cytokine gene expression Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D50 - D52. [Abstract] [PDF]
|
|
|
|
|
|
R.B. Singh, M.A. Niaz, and C. Kartik Can n-3 fatty acids provide myocardial protection by decreasing infarct size and inhibiting atherothrombosis? Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D62 - D69. [Abstract] [PDF]
|
|
|
|
|
|
R. Marchioli Treatment with n-3 polyunsaturated fatty acids after myocardial infarction: results of GISSI-prevenzione trial Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D85 - D97. [Abstract] [PDF]
|
|
|
|
|
|
R. M. Krauss, R. H. Eckel, B. Howard, L. J. Appel, S. R. Daniels, R. J. Deckelbaum, J. W. Erdman Jr, P. Kris-Etherton, I. J. Goldberg, T. A. Kotchen, et al. AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association J. Nutr., January 1, 2001; 131(1): 132 - 146. [Full Text]
|
|
|
|
|
|
P. Angerer, U. Siebert, W. Kothny, D. Muhlbauer, H. Mudra, and C. von Schacky Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1781 - 1788. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Vogel, M. C. Corretti, and G. D. Plotnick The postprandial effect of components of the mediterranean diet on endothelial function J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1455 - 1460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
K. D Stark, E. J Park, V. A Maines, and B. J Holub Effect of a fish-oil concentrate on serum lipids in postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-controlled, double-blind trial Am. J. Clinical Nutrition, August 1, 2000; 72(2): 389 - 394. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Fish Oil May Slow Coronary Atherosclerosis Journal Watch Dermatology, June 1, 1999; 1999(601): 14 - 14. [Full Text]
|
|
|
|
 |
|
 Fish Oil and Coronary Atherosclerosis Journal Watch Cardiology, May 21, 1999; 1999(521): 3 - 3. [Full Text]
|
|
|
|
 |
|
 Fish Oil May Slow Coronary Atherosclerosis Journal Watch (General), April 23, 1999; 1999(423): 4 - 4. [Full Text]
|
|
|
|
 |
|
 E. A. Fisher, M. Pan, X. Chen, X. Wu, H. Wang, H. Jamil, J. D. Sparks, and K. J. Williams The Triple Threat to Nascent Apolipoprotein B. EVIDENCE FOR MULTIPLE, DISTINCT DEGRADATIVE PATHWAYS J. Biol. Chem., July 20, 2001; 276(30): 27855 - 27863. [Abstract] [Full Text] [PDF]
|
|
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