Randomized, Double-Blind, Placebo-Controlled Trial of Fish Oil and Mustard Oil in Patients with Suspected Acute Myocardial Infarction: The Indian Experiment of Infarct Survival—4 Article DOI:
Cite this article as: Singh, R.B., Niaz, M.A., Sharma, J.P. et al. Cardiovasc Drugs Ther (1997) 11: 485. doi:10.1023/A:1007757724505 Abstract
In a randomized, placebo-controlled trial, the effects of treatment with fish oil (eicosapentaenoic acid, 1.08 g/day) and mustard oil (alpha-linolenic acid, 2.9 g/day) were compared for 1 year in the management of 122 patients (fish oil, group A), 120 patients (mustard oil, group B), and 118 patients (placebo, group C) with suspected acute myocardial infarction (AMI). Treatments were administered about (mean) 18 hours after the symptoms of AMI in all three groups. The extent of cardiac disease, rise in cardiac enzymes, and lipid peroxides were comparable among the groups at entry into the study. After 1 year total cardiac events were significantly less in the fish oil and mustard oil groups compared with the placebo group (24.5% and 28% vs. 34.7%, p > 0.01). Nonfatal infarctions were also significantly less in the fish oil and mustard oil groups compared with the placebo group (13.0% and 15.0% vs. 25.4%, p > 0.05). Total cardiac deaths showed no significant reduction in the mustard oil group; however, the fish oil group had significantly less cardiac deaths compared with the placebo group (11.4% vs. 22.0%, p > 0.05). Apart from the decrease in the cardiac event rate, the fish oil and mustard oil groups also showed a significant reduction in total cardiac arrhythmias, left ventricular enlargement, and angina pectoris compared with the placebo group. Reductions in blood lipoproteins in the two intervention groups were modest and do not appear to be the cause of the benefit in the two groups. Diene conjugates showed a significant reduction in the fish oil and mustard oil groups, indicating that a part of the benefit may be caused by the reduction in oxidative stress. The findings of this study suggest that fish oil and mustard oil, possibly due to the presence of n-3 fatty acids, may provide rapid protective effects in patients with AMI. However, a large study is necessary to confirm this suggestion.
alpha linolenic acid eicosapentaenoic acid fish oil mustard oil acute myocardial infarction References
Shekelle RB, Stamler J. Fish and coronary heart disease: The epidemiologic evidence.
Nutr Metab Cardiovasc Dis
Renad S, deLorgeril M. Dietary lipids and their relation to ischaemic heart disease from epidemiology to prevention
J Interm Med
Seven Countries, a Multivariate Analysis of Diet and Coronary Heart Disease
. Cambridge: Harvard University Press, 1980:67.
Kromhout D, Bosschieter EB, Coulander CDL. The inverse relation between fish consumption and 20-year mortality from coronary heart disease.
N Engl J Med
Riemersma RA, Sargent CA. Dietary fish oil and ischaemic arrhythmias.
J Intern Med
McLennan PL. Relative effects of dietary saturated, monounsaturated and polyunsaturated fatty acids on cardiac arrhythmias in rats.
Am J Clin Nutr
Billman GE, Hallaq H, Leof A. Prevention of ischemia-induced ventricular fibrillation by omega-3 fatty acids.
Proc Natl Acad Sci USA
Nussboum ME. Dietary fish oil supplementation attenuates myocardial dysfunction and injury caused by global ischemia and reperfusion in isolated rat hearts.
J Parenter Enter Nutr
Ostsuji S, Shibata N, Hirota H, Akagami H, Wada A. Highly purified eicosapentaenoic acid attenuotos tissue damage in experimental myocardial infarction.
Jpn Circ J
Yang BC, Saldeon TG, Bryant JI, Nichols WW, Mehta JI. Long term dietary fish oil supplementation protects against ischemia-reperfusion-induced myocardial dysfunction in isolated rat hearts.
Am Heart J
Zhu BQ, Sievers RE, Sun YP, Morse-Fisher N, Parmley WW, Woffe CL. Is the reduction of myocardial infarct size by dietary fish oil the result of altered platelet function?
Am Heart J
Chen MF, Hsu HC, Chen WJ, et al. Fish oil supplementation attenuates free radical generation in short term coronary occlusion-reperfusion in cholesterol-fed rabbits.
Chen MF, Hsu HC, Leet YT. Effects of fish oil supplementation on the changes in myocardial cyclic adenosine monophosphate, inosital 1,4,5-triphosphate and mitochondrial calcium levels during acute coronary occlusion-reperfusion in cholesterol-fed rabbits.
Int J Cardiol
Grech ED, Jackson MJ, Ramsdale, DR. Reperfusion injury after acute myocardial infarction.
Br Med J
Cotton P. Restenosis trials suggest role for remodeling.
Burr ML, Fehly AM, Gilbert JF, et al. Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction: Diet and Reinfarction Trial (DART).
deLargeril M, Renaud S, Mamelle N, et al. Mediterranean alpha linolenic acid-rich diet in secondary prevention of coronary heart disease.
Singh RB, Rastgoi SS, Verma R, Bolaki L, Singh R. An Indian experiment with nutritional modulation in acute myocardial infarction.
Am J Cardiol
Singh RB, Niaz MA, Agarwal P, Beegom R, Rastogi SS. Effects of antioxidant-rich foods on plasma ascorbic acid, cardiac enzyme and lipid peroxide levels in patients hospitalized with acute myocardial infarction.
J Am Diet Assoc
Grech EO, Dodd NJF, Bellamy CM, Faragher EB, MOrrison WL, Ramsdale DR. Detection of circulating free radicals following angioplasty reperfusion for acute myocardial infarction.
Chan JK, McDonald BE, Gerrard JM, Bruce VM, Weaver BJ, Holub BJ. Effect of dietary alpha-linolenic acid and its ratio to linolenic acid on platelet and plasma fatty acids: to and thrombogenesis.
World Health Organization Myocardial infarction community registers. Copenhagen: World Health Organization, 1976.
National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).
Allain CC, Poon LS, Chan, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol.
Finley PR, Schifman RB, Williams RJ, Lichti DA. Cholesterol in high density lipoprotein: Use of magnesium/dextran sulphate in its enzymatic measurement.
Buclo G, David H. Quantitative determination of serum triglycerides by the use of enzymes.
Lunec J, Halloran SP, White AG, Dormandy TL. Free radical oxidation (peroxidation) products in serum and synovial fluids in rheumatoid arthritis.
Elwood P, Renand S, Sharp DS, Beswick AD, O'Brien JR, Yarnell JWG. Ischemic heart disease and platelet aggregation: The Caerphilly Collaborative Heart Disease Study.
Thaulow R, Eriksson J, Sandvik J, Stormorken H, Cohn PF. Blood platelet count and function are related to total and cardiovascular death in apparently healthy men.
Indu M, Ghafoorinissa. n-3 fatty acids in the Indian diets: Comparison of the effects of precursor (alpha-linolenic acid) vs. product long-chain n-3 polyunsaturated fatty acids).
Law MR, Wald NJ, Thompson SG. By how much and how quickly does reduction in serum cholesterol concentration lower the risk of ischaemic heart disease.
Dr Med J
Morris JN, Ball KP, Antonil A. Controlled trial of soybean oil in myocardial infarction.
Google Scholar Copyright information
© Kluwer Academic Publishers 1997