Positive Health Online

Abstract

GRUPPO ITALIANO per lo Studio della Sopravvivenza nellInfarto miocardico investigated the effects of supplemental n-3 polyunsaturated fatty acids (PUFA) in patients with heart attack .

Background

There is conflicting evidence regarding the benefits of foods rich in vitamin E and n-3 polyunsaturated fatty acids (PUFA).

Methodology

11,324 patients surviving recent (less than 3 months) heart attack, were randomly assigned supplements of n-3 PUFA (1 g daily, n = 2836), vitamin E (300 mg daily, n = 2830), both (n = 2830) or none (control, n = 2828) for 3.5 years. Primary combined endpoint was death, non-fatal heart attack and stroke. Intention-to-treat analyses were performed by a 2-way factorial design and by treatment group (4-way).

Results

Treatment with n-3 PUFA, but not vitamin E, significantly lowered risk of primary endpoint (relative-risk decrease 10% by 2-way analysis, 15% by 4-way analysis). The benefit was attributable to a decrease in the risk of death (14%, 2-way, 20% 4-way) and cardiovascular death (17% 2-way, 30% 4-way). The effect of the combined treatment was similar to that for n-3 PUFA for the primary endpoint (14% and for fatal events (20%).

Conclusion

Dietary supplementation with n-3 PUFA resulted in a clinically important and statistically significant decrease in risk of death and cardiovascular death . Vitamin E had no effect; its effects upon fatal cardiovascular events need to be further explored.

References

Gruppo Italiano per lo Studio della Sopravvivenza nellInfarto miocardico. Lancet 354 (9177): 447-55. 7 Aug 1999.