The American Heart Association recently released a scientific position statement in Circulation regarding the reasonable benefits of supplementation with marine based omega-3 polyunsaturated fatty acids (PUFAs) for secondary prevention in cardiovascular disease (CVD).
The advisory board evaluated evidence from numerous randomized clinical trials (RCTs) related to the use of omega-3 PUFA supplements to reduce the risk of clinical CVD. Clinical CVD, for this position statement, was determined to include the following disease states: coronary heart disease (CHD), atrial fibrillation (AF), sudden cardiac death (SCD), heart failure (HF), stroke and myocardial infarct (MI). The advisory board’s main conclusion was that treatment with omega-3 polyunsaturated fatty acids in patients with recent MI is reasonable to prevent CHD death.
The findings from the advisory board included:
- Based on the recent results from the GISSI-HF study, there are reasonable benefits with omega-3 treatment for patients with HF, reduced ejection fraction (EF) due to the observed reductions on overall mortality and hospitalizations for CVD
- Reasonable benefits with omega-3 treatment for hypercholesterolemia
While the advisory group did support the reasonable benefits of omega-3 treatment in HF, they also urged that more trials are needed “to determine whether the benefits of omega-3 PUFA supplementation on prognosis vary according to the type, severity, and cause of heart failure.” HF is a heterogeneous disease mostly found in women and older adults.
The position statement further noted that there have been no RCTs designed to assess omega-3s for prevention of HF, AF, MI or recurrent stroke, so no recommendation was made in this position statement regarding use of omega-3 supplementation as a preventive measure in these disease states.
Why is this clinically relevant?
- In patients with prior history of MI, fish oil supplementation may reduce subsequent HF related hospitalizations and cardiovascular death, particularly in those patients with reduced EF