, Volume 34, Supplement 1, pp S303–S305 | Cite as

n-3 fatty acids and coronary heart disease—the urgent need of clinical trials

Clinical Trials And New Products


Data from epidemiological studies, animal experiments, and clinical trials of biochemical effects in humans lend support for a beneficial role of n-3 PUFA in CHD. So far only a few trials of n-3 PUFA with clinical endpoints have been published. Further clinical studies in patients with acute myocardial ischemia, post-MI patients, patients undergoing coronary bypass surgery or stenting during PTCA, and patients with arrhythmias should be undertaken. Only results from controlled clinical trials with hard end points can establish whether n-3 PUFA reduce the risk of CHD and will have an impact on patient treatment.



coronary heart disease


myocardial infarction


percutaneous transluminal coronary angioplasty

n-3 PUFA

n-3 polyunsaturated fatty acid


  1. 1.
    Bang, H.O., Dyerberg, J., and Nielsen, A.B. (1971) Plasma Lipid and Lipoprotein Pattern in Greenlandic West Coast Eskimos,Lancet i, 1143–1146.CrossRefGoogle Scholar
  2. 2.
    Dyerberg, J., Bang, H.O., Stoffersen, E., Moncada, S., and Vane, J.R. (1978) Eicosapentaenoic Acid and Prevention of Thrombosis and Atherosclerosis?Lancet ii, 117–119.CrossRefGoogle Scholar
  3. 3.
    Dyerberg, J., and Bang, H.O. (1979) Hæmostatic Function and Platelet Polyunsaturated Fatty Acids in Eskimos,Lancet ii, 433–435.CrossRefGoogle Scholar
  4. 4.
    Bang, H.O., Dyerberg, J., and Sinclair, H.M. (1980) The Composition of Eskimo Food in North-Western Greenland,Am. J. Clin. Nutr. 33, 2657–2661.PubMedGoogle Scholar
  5. 5.
    Fischer, S., Weber, P.C., and Dyerberg, J. (1986) The Prostacyclin/Thromboxane Balance Is Favourably Shifted in Greenland Eskimos,Prostaglandins 32, 235–241.PubMedCrossRefGoogle Scholar
  6. 6.
    Schmidt, E.B., and Dyerberg, J. (1994) Omega-3 Fatty Acids: Current Status in Cardiovascular Medicine,Drugs 47, 405–424.PubMedCrossRefGoogle Scholar
  7. 7.
    Schmidt, E.B. (1997) n-3 Fatty Acids and the Risk of Coronary Heart Disease,Dan. Med. Bull. 44, 1–22.PubMedGoogle Scholar
  8. 8.
    Saynor, R., Verel, D., and Gillott, T. (1984) The Long-Term Effect of Dietary Supplementation with Fish Lipid Concentrate on Serum Lipids, Bleeding Time, Platelets and Angina,Atherosclerosis 50, 3–10.PubMedCrossRefGoogle Scholar
  9. 9.
    Kristensen, S.D., Schmidt, E.B., Andersen, H.R., and Dyerberg, J. (1987) Fish Oil in Angina Pectoris,Atherosclerosis 64, 13–19.PubMedCrossRefGoogle Scholar
  10. 10.
    Landmark, K., Abdelnoor, M., Kilhovd, B., and Dørum, H.-P. (1998) Eating Fish May Reduce Infarct Size and the Occurrence of Q Wave Infarcts,Eur. J. Clin. Nutr. 52, 40–44.PubMedCrossRefGoogle Scholar
  11. 11.
    Daviglus, M.L., Stamler, J., Orencia, A.J., Dyer, A.R., Liu, K., Greenland, P., Walsh, M.K., Morris, D., and Shekelle, R.B. (1997) Fish Consumption and the 30-Year Risk of Fatal Myocardial Infarction,N. Engl. J. Med. 336, 1046–1053.PubMedCrossRefGoogle Scholar
  12. 12.
    Burr, M.L., Fehily, A.M., Gilbert, J.F., Rogers, S., Holliday, R.M., Sweetnam, P., Elwood, P.C., and Deadman, N.M. (1989) Effects of Changes in Fat, Fish, and Fibre Intakes on Death and Myocardial Reinfarction: Diet and Reinfarction Trial (DART),Lancet ii, 757–761.CrossRefGoogle Scholar
  13. 13.
    de Lorgeril, M., Salen, P., Martin, J.-L., Mamelle, N., Touboul, P., and Delaye, J. (1996) Effect of a Mediterranean Type Diet on the Rate of Cardiovascular Complications in Patients with Coronary Artery Disease,J. Am. Coll. Cardiol. 28, 1103–1108.PubMedCrossRefGoogle Scholar
  14. 14.
    Eritsland, J., Arnesen, H., Grønseth, K., Fjeld, N.B., and Abdelnoor, M. (1996) Effect of Dietary Supplementation with n-3 Fatty Acids on Coronary Artery Bypass Graft Patency,Am. J. Cardiol. 77, 31–36.PubMedCrossRefGoogle Scholar
  15. 15.
    Gapinski, J.P., VanRuiswyk, J.V., Heudebert, G.R., and Schectman, G.S. (1993) Preventing Restenosis with Fish Oils Following Coronary Angioplasty. A Meta-Analysis,Arch. Intern. Med. 153, 1595–1601.PubMedCrossRefGoogle Scholar
  16. 16.
    Cairns, J.A., Gill, J., Morton, B., Roberts, R., Gent, M., Hirsh, J., Holder, D., Finnie, K., Marquis, J.F., Naqvi, A., and Cohen, E. (1994) Fish Oils and Low-Molecular-Weight Heparin for the Reduction of Restenosis After Percutaneous Transluminal Coronary Angioplasty,Circulation 94, 1553–1560.Google Scholar
  17. 17.
    Leaf, A., Jorgensen, M.B., and Jacobs, A.K. (1994) Do Fish Oils Prevent Restenosis After Coronary Angioplasty?Circulation 90, 2248–2257.PubMedGoogle Scholar
  18. 18.
    McLennan, P.L. (1993) Relative Effects of Dietary Saturated, Monounsaturated, and Polyunsaturated Fatty Acids on Cardiac Arrhythmias in Rats,Am. J. Clin. Nutr. 57, 207–212.PubMedGoogle Scholar
  19. 19.
    Kang, J.X., and Leaf, A. (1996) Antiarrhythmic Effects of Polyunsaturated Fatty Acids. Recent Studies,Circulation 94, 1774–1780.PubMedGoogle Scholar
  20. 20.
    Luostarinen, R., Boberg, M., and Saldeen, T. (1993) Fatty Acid Composition in Total Phospholipids of Human Coronary Arteries in Sudden Cardiac Death,Atherosclerosis 99, 187–193.PubMedCrossRefGoogle Scholar
  21. 21.
    Siscovick, D.S., Raghunathan, T.E., King, I., Weinmann, S., Wicklund, K.G., Albright, J., Bovbjerg, V., Arbogast, P., Smith, H., Kushi, L.H., Cobb, L.A., Copass, M.K., Psaty, B.M., Lemaitre, R., Retzlaft, B., Childs, M., and Knapp, R.H. (1995) Dietary Intake and Cell Membrane Levels of Long-Chain n-3 Polyunsaturated Fatty Acids and the Risk of Primary Cardiac Arrest,JAMA 274, 1363–1367.PubMedCrossRefGoogle Scholar
  22. 22.
    Albert, C.M., Hennekens, C.H., O’Donnell, C.J., Ajani, U.A., Carey, V.J., Willett, W.C., Ruskin, J.N., and Manson, J.E. (1998) Fish Consumption and Risk of Sudden Cardiac Death,JAMA 279, 23–28.PubMedCrossRefGoogle Scholar
  23. 23.
    Christensen, J.H., Gustenhoff, P., Korup, E., Aarøe, J., Toft, E., Møller, J., Rasmussen, K., Dyerberg, J., and Schmidt, E.B. (1996) Effect of Fish Oil on Heart Rate Variability in Survivors of Myocardial Infarction: A Double Blind Randomised Controlled Trial,Br. Med. J. 312, 677–678.Google Scholar
  24. 24.
    Hardarson, T., Kristinsson, A., Skuladottir, G., Asvalddottir, H., and Snorrason, S.P. (1989) Cod Liver Oil Does Not Reduce Ventricular Extrasystoles After Myocardial Infarction,J. Intern. Med. 226, 33–37.PubMedGoogle Scholar
  25. 25.
    Christensen, J.H., Gustenhoff, P., Ejlersen, E., Jessen, T., Korup, E., Rasmussen, K., Dyerberg, J., and Schmidt, E.B. (1995) n-3 Fatty Acids and Ventricular Extrasystoles in Patients with Ventricular Tachyarrhythmias,Nutr. Res. 15, 1–8.CrossRefGoogle Scholar
  26. 26.
    Sellmayer, A., Witzgall, H., Lorenz, R.L., and Weber, P.C. (1995) Effects of Dietary Fish Oil on Ventricular Premature Complexes,Am. J. Cardiol. 76, 974–977.PubMedCrossRefGoogle Scholar
  27. 27.
    Kromhout, D., Feskens, E.J.M., and Bowles, C.H. (1995) The Protective Effect of a Small Amount of Fish on Coronary Heart Disease Mortality in an Elderly Population,Int. J. Epidemiol. 24, 340–345.PubMedCrossRefGoogle Scholar

Copyright information

© AOCS Press 1999

Authors and Affiliations

  1. 1.Department of MedicineHjørring/Brønderslev HospitalDenmark
  2. 2.Medi-Lab a.s.Copenhagen KDenmark

Personalised recommendations