American Heart Association
Giving heart attack patients a high dose of omega-3 fatty acids
from fish oil, daily for six months after a heart attack improved the function
of the heart and reduced scarring in the undamaged muscle, according to new
research in the American Heart Association's journal Circulation.
The heart's shape and function can be altered after a heart
attack, a condition known as post-heart attack remodeling and it is linked with
poor patient outcomes and could lead to heart failure.
Therapies that can
improve healing of the heart or prevent adverse remodeling, remain scarce.
A previous study found that omega-3 fatty acids from fish oil
were associated with improved survival for heart attack patients, but the role
of omega-3 fatty acids in improving the structure and tissue of the heart in
patients receiving current guideline-based therapy after a heart attack was
unknown.
In the new OMEGA-REMODEL randomized clinical trial, researchers found compared to those taking a placebo, patients taking a dose of 4 grams of omega-3 fatty acids daily for six months:
experienced a 5.8 percent reduction in left ventricular
end-systolic volume index: a clinical marker that can predict patient outcome
after a heart attack; and had a 5.6 percent reduction in a measurement of
scarred connective tissue (fibrosis) formation in the non-damaged heart muscle.
"Heart failure is still a major problem after a heart
attack despite all the therapy we have and the advances in interventional
care," said Raymond Y. Kwong, M.D., M.P.H., senior author of the study and
director of Cardiac Magnetic Resonance Imaging, Brigham and Women's Hospital
and an associate professor of medicine at Harvard Medical School in Boston,
Massachusetts.
"Our findings show that omega-3 fatty acids are a safe and
effective treatment in improving cardiac remodeling, so it may be promising in
reducing the incidence of heart failure or death, which are still major
healthcare burdens to patients who suffer a heart attack."
Researchers said these results suggests that omega-3 fatty acids
allow the heart to contract better, and also reduces the fibrosis in the region
that is not damaged.
The researchers also observed a reduction in biomarkers for
inflammation, suggesting that omega-3 fatty acids have some anti-inflammatory
properties.
The study involved 360 heart attack survivors, half were given a
high dose omega-3 fatty acids and half placebo, beginning within a month of the
heart attack.
Because the study participants were given high doses of omega-3s
in addition to their other medications, patients were under a physician's care
and observed for any potential adverse outcomes by study authors throughout the
study.
The treatment was found to be safe and effective. Both groups
received treatment based on guidelines issued by the American College of Cardiology
Foundation and the American Heart Association. Blood tests were used to confirm
that patients in the omega-3 fatty acids group were taking the treatment.
Co-authors are Bobak Heydari, M.D., M.P.H.; Shuaib Abdullah,
M.D.; James V. Pottala, Ph.D.; Ravi Shah, M.D.; Siddique Abbasi, M.D.; Damien
Mandry, M.D., Ph.D.; Sanjeev A. Francis, M.D.; Heidi Lumish, B.S.; Brian B.
Ghoshhajra, M.D.; Udo Hoffman, M.D.; Evan Appelbaum, M.D.; Jiazhuo H. Feng,
B.S.; Ron Blankstein, M.D.; Michael Steigner, M.D.; Joseph P. McConnell, Ph.D.;
William Harris, Ph.D.; Elliott M. Antman, M.D.; and Michael Jerosch-Herold,
Ph.D. Author disclosures are on the manuscript.
The National Heart, Lung, and Blood Institute funded this study.
