Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction: The OMEGA-REMODEL Randomized Clinical Trial

This study of 358 people who presented with an acute MI (myocardial infarct) were randomized to receive high dose omega 3 FA (4gm/day) or placebo for 6 months in conjunction with standard therapy (angioplasty). Cardiac imaging was performed at baseline and after 6 months to assess cardiac structure (tissue fibrosis), LVEF (a measure of how well the heart pumps with each contraction) and other markers of left cardiac remodeling.  Also measured were the standard serum biomarkers of systemic inflammation.

Results in patients who received the fish oil:

  • Had a 5.8% decrease in their left ventricular systolic volume index (LVSVI; P = .017) and 5.6% less fibrosis in their non-infarcted myocardium—both markers of improved cardiac function
  • Underwent significant reductions in serum biomarkers of systemic and vascular inflammation and myocardial fibrosis including hs-CRP, NT-proBNP and Lp-PLA2

Why is this clinically significant?

  • Following a heart attack, patients may have numerous complications and are most often a result due to the ischemia (lack of blood flow) of the injured cardiac tissue. The injured heart tissue, combined with the lack of blood flow to it, commonly results in fibrosis or abnormal thickening. The fibrosed tissue is less elastic and less able to pump blood efficiently through the body and over time may be responsible for congestive heart failure(CHF).  CHF is a progressive disease that can worsen over time with increased risk for morbidity and mortality
  • This study showed that high dose omega 3 FA given immediately after an MI,  had a positive effect on the injured heart tissue by reducing the amount of fibrosis and reducing the risk for CHF
  • Furthermore, the study also showed in those patients given high dose omega 3FA, their biomarkers of inflammation were significantly reduced as compared to the placebo group

Conclusions

  • This study provides preliminary data to suggest that omega 3FA in high doses may have beneficial effects on ventricular remodeling and resultant and immediate inflammation post MI
    • Particularly may reduce risk of CHF post MI
  • While results are positive, this study should be replicated with greater patient numbers and over a longer period of time
  • The authors note that the fish oils used were highly concentrated—more than what is currently available OTC

Read the Abstract 

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