Skip to main content
SpringerLink
Log in

Efficacy of n-3 polyunsaturated fatty acids after myocardial infarction: Results of GISSI-prevenzione trial

  • Published:
Lipids

Abstract

Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardio (GISSI)-Prevenzione was conceived as a population, pragmatic trial on patients with recent myocardial infarctions conducted in the framework of the Italian public health system. In GISSI-Prevenzione, patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term n-3 PUFA (1 g daily) but not vitamin E (300 mg daily), was beneficial for death and for combined death, nonfatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall, cardiovascular, cardiac, coronary, and sudden death.

At variance with the orientation of a scientific scenario largely dominated by the “cholesterol-heart hypothesis”, GISSI-Prevenzione results indicate n-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction.

As to the relevance and comparability of GISSI-Prevenzione results, up to 5.7 lives could be saved every 1000 patients with previous myocardial infarction treated with n-3 PUFA (1 g daily) per year. Such a result is comparable to that observed in the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) trial, where 5.2 lives could be saved per 1000 hypercholesterolemic, coronary heart disease patients treated with pravastatin for 1 yr.

The choice of a relatively low-dose regimen (1-g capsule daily) more acceptable for long-term treatment in a population of patients following Mediterranean dietary habits, and the pattern of effects seen in GISSI-Prevenzione (namely, reduction of overall mortality with no decrease in the rate of nonfatal myocardial infarction) all strongly suggest that n-3 PUFA treatment should be considered a recommended new component of secondary prevention. The importance of this combined/additive effect is further suggested by the analyses of the interplay between diet and n-3 PUFA: There is an interesting direct correlation between size of the effect and “correctness” of background diets. It can be anticipated that a conceptual barrier must be overcome: A “dietary drug” should be added to “dietary advice”, which remains fundamental to allow this statement to become true in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ACE:

angiotensin-converting enzyme

CHD:

coronary heart disease

CI:

confidence interval

DART:

Diet and Reinfarction Trial

DHA:

docosahexaenoic acid

EPA:

eicosapentaenoic acid

GISSI:

Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico

PUFA:

polyunsaturated fatty acids

References

  1. Bang, H.O., Dyerberg, J., and Hjørne, N. (1976) The Composition of Food Consumed by Greenland Eskimos, Acta Med. Scand. 200, 69–73.

    Article  PubMed  CAS  Google Scholar 

  2. Kromann, N., and Green, A. (1980) Epidemiologic Studies in the Upernavik District, Greenland, Incidence of Some Chronic Disease (1950–1974), Acta. Med. Scand. 208, 401–406.

    Article  PubMed  CAS  Google Scholar 

  3. Simopoulos, A.P. (1991) Omega-3 Fatty Acids in Health and Disease and Growth and Development, Am. J. Clin. Nutr. 54, 438–463.

    PubMed  CAS  Google Scholar 

  4. Simopoulos, A.P. (1997) ω-3 Fatty Acids in The Prevention-Management of Cardiovascular Disease, Can. J. Physiol. Pharmacol. 75, 234–239.

    Article  PubMed  CAS  Google Scholar 

  5. Ascherio, A., Rimm, E.B., Stampfer, M.J., Giovannucci, E.L., and Willett, W.C. (1995) Dietary Intake of Marine n-3 Fatty Acids. Fish Intake and the Risk of Coronary Disease Among Men, N. Engl. J. Med. 332, 977–982.

    Article  PubMed  CAS  Google Scholar 

  6. 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).

  7. Kromhout, D., Bosschieter, E.B., and de Lezenne, C.C. (1985) The Inverse Relationship Between Fish Consumption and 20-Year Mortality from Coronary Heart Disease, N. Engl. J. Med. 312, 1205–1209.

    Article  PubMed  CAS  Google Scholar 

  8. 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.

    Article  PubMed  CAS  Google Scholar 

  9. Dolecek, T.A. (1992) Epidemiological Evidence of Relationships Between Dietary Polyunsaturated Fatty Acids and Mortality in The Multiple Risk Factor Intervention Trial, Proc. Soc. Exp. Biol. Med. 200, 177–182.

    PubMed  CAS  Google Scholar 

  10. Rodriguez, B.L., Sharp, D.S., Abbott, R.D., Burchfiel, C.M., Masaki, K., Chyou, P.H., Huang, B., Yano, K., and Curb, J.D. (1996) Fish Intake May Limit the Increase in Risk of Coronary Heart Disease Morbidity and Mortality Among Heavy Smokers: The Honolulu Heart Program, Circulation 94, 952–956.

    PubMed  CAS  Google Scholar 

  11. De Lorgeril, M., Salen, P., Martin, J.-L., Moniaud, I., Delaye, J., and Mamelle, N. (1999) Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction: Final Report of the Lyon Diet Heart Study, Circulation 99, 779–785.

    PubMed  Google Scholar 

  12. Singh, R.B., Rastogi, S.S., Verma, R., Laxmi, B., Singh, R., Ghosh, S., and Niaz, M.A. (1992) Randomised Controlled Trial of Cardioprotective Diet in Patients with Recent Acute Myocardial Infarction: Results of One Year Follow-Up, Br. Med. J. 304, 1015–1019.

    Article  CAS  Google Scholar 

  13. Singh, R.B., Rastogi, S.S., Rao, P.V., Das, S., Madhu, S.V., Das, A.K., Sahay, B.K., Fuse, S.M., Beegom, R., Sainani, G.S., et al. (1997) 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, Cardiovasc. Drug Ther. 11, 485–491.

    Article  CAS  Google Scholar 

  14. von Shacky, C., Angerer, P., Kothny, W., Theisen, K., and Mudra, H. (1999) The Effect of Dietary Omega-3 Fatty Acids on Coronary Atherosclerosis. A Randomized, Double-Blind, Placebo-Controlled Trial, Ann. Intern. Med. 130, 554–562.

    Google Scholar 

  15. Burr, M.L., Fehily, A.M., Gilbert, J.F., Rogers, S., Holliday, R.M., Sweetnam, P.M., 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.

    Article  Google Scholar 

  16. Harris, W.S. (1997) n-3 Fatty Acids and Serum Lipoproteins: Human Studies, Am. J. Clin. Nutr. 65 (Suppl. 5), 1645S-1654S.

    PubMed  CAS  Google Scholar 

  17. Harris, W.S. (1997) n-3 Fatty Acids and Serum Lipoproteins: Animal Studies, Am. J. Clin. Nutr. 65 (Suppl. 5), 1611S-1616S.

    PubMed  CAS  Google Scholar 

  18. McLennan, P.L., Bridle, T.M., Abeywardena, M.Y., and Charnok, J.S. (1992) Dietary Lipid Modulation of Ventricular Fibrillation Threshold in the Marmoset Monkey, Am. Heart J. 123, 1555–1561.

    Article  PubMed  CAS  Google Scholar 

  19. 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.

    PubMed  CAS  Google Scholar 

  20. Kang, J.X., and Leaf, A. (1996) Antiarrhythmic Effects of Polyunsaturated Fatty Acids: Recent Studies, Circulation 94, 1774–80.

    PubMed  CAS  Google Scholar 

  21. Billman, G.E., Kang, J.X., and Leaf, A. (1999) Prevention of Ischemia-Induced Ventricular Arrhythmias by Dietary Pure n-3 Polyunsaturated Fatty Acids in Dogs, Circulation 99, 2452–2457.

    PubMed  CAS  Google Scholar 

  22. 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.

    Article  PubMed  CAS  Google Scholar 

  23. Christensen, J.H., Gustenhoff, P., Korup, E., Aaroe, J., Toft, E., Moller, 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.

    CAS  Google Scholar 

  24. Christensen, J.H., Korup, E., Aaroe, J., Toft, E., Moller, J., Rasmussen, K., Dyerberg, J., and Schmidt, E.B. (1997) Fish Consumption, n-3 Fatty Acids in Cell Membranes, and Heart Rate Variability in Survivors of Myocardial Infarction with Left Ventricular Dysfunction, Am. J. Cardiol. 79, 1670–1673.

    Article  PubMed  CAS  Google Scholar 

  25. Siscovick, D.S., Raghunathan, T.E., King, I., Weinmann, S., Wicklund, K.G., Albright, J., Bovbjerg, V., Arbogast, P., Smith, H., Kushi, L.H., et al. (1995) Dietary Intake and Cell Membrane Levels of Long-Chain ω-3 Polyunsaturated Fatty Acids and the Risk of Primary Cardiac Arrest, J. Am. Med. Assoc. 274, 1363–1367.

    Article  CAS  Google Scholar 

  26. Kang, J.X., and Leaf, A. (1994) Effects of Long-Chain Polyunsaturated Fatty Acids on the Contraction of Neonatal Rat Cardiac Myocytes, Proc. Natl. Acad. Sci. USA 91, 9886–9890.

    Article  PubMed  CAS  Google Scholar 

  27. Kang, J.X., and Leaf, A. (1995) Prevention and Termination of the β-Adrenergic Agonist-Induced Arrhythmias by Free Polyunsaturated Fatty Acids in Neonatal Rat Cardiac Myocytes, Biochem. Biophys. Res. Commun. 208, 629–636.

    Article  PubMed  CAS  Google Scholar 

  28. Kang, J.X., Xiao, Y.-F., and Leaf, A. (1995) Free, Long-Chain, Polyunsaturated Fatty Acids Reduce Membrane Electrical Excitability in Neonatal Rat Cardiac Myocytes, Proc. Natl. Acad. Sci. USA 92, 3997–4001.

    Article  PubMed  CAS  Google Scholar 

  29. Xiao, Y.-F., Kang, J.X., Morgan, J.P., and Leaf, A. (1995) Blocking Effects of Polyunsaturated Fatty Acids on Na+ Channels of Neonatal Rat Ventricular Myocytes, Proc. Natl. Acad. Sci. USA, 92, 1100–1104.

    Google Scholar 

  30. Xiao, Y.-F., Gomez, A.M., Morgan, J.P., Lederer, W.J., and Leaf, A. (1997) Suppression of Voltage-Gated L-Type Ca2+ Currents by Polyunsaturated Fatty Acids in Adult and Neonatal Rat Cardiac Myocytes, Proc. Natl. Acad. Sci. USA 94, 4182–4187.

    Article  PubMed  CAS  Google Scholar 

  31. Xiao, Y.-F., Wright, S.N., Wang, J.K., Morgan, J.P., and Leaf, A. (1998) n-3 Fatty Acids Suppress Voltage-Gated Na+ Currents in Hek293t Cells Transfected with the Subunit of the Human Cardiac Na+ Channel, Proc. Natl. Acad. Sci. USA 95, 2680–2685.

    Article  PubMed  CAS  Google Scholar 

  32. Marchioli, R., and Di Pasquale, A., for the Ricercatori GISSI Prevenzione (1993) Il Quadro di Riferimento Biochimico, Farmacologico, Epidemiologico del Gissi-Prevenzione, G. Ital. Cardiol. 23, 933–964.

    PubMed  CAS  Google Scholar 

  33. Gruppo Italiano Studio Sulla Sopravvivenza nell'Infarto Miocardico (GISSI) (1993) Il Protocollo Dello Studio Gissi-Prevenzione: Studio di Intervento Preventivo Sulle Componenti Aterosclerotica e Trombotica Del Rischio Post-Infarto, G. Ital. Cardiol. 23 1053–1061.

    Google Scholar 

  34. GISSI-Prevenzione Investigators (1999) Dietary Supplementation with n-3 Polyunsaturated Fatty Acids and Vitamin E After Myocardial Infarction: Results of the GISSI-Prevenzione Trial, Lancet 354, 447–455.

    Article  Google Scholar 

  35. Meydani, M., Natiello, F., Goldin, B., Free, N., Woods, M., Schaefer, E., Blumberg, J.B., and Gorbach, S.L. (1991) Effect of Long-Term Fish Oil Supplementation on Vitamin E Status and Lipid Peroxidation in Women, J. Nutr. 121, 484–491.

    PubMed  CAS  Google Scholar 

  36. Marchioli, R. (1999) Antioxidant Vitamins and Prevention of Cardiovascular Disease: Laboratory, Epidemiological, and Clinical Trial Data, Pharmacol. Res. 40, 227–238.

    Article  PubMed  CAS  Google Scholar 

  37. Steinberg, D., Parthasarathy, S., Carew, T.E., Khoo, J.C., and Witztum, J.L. (1989) Beyond Cholesterol: Modifications of Low-density Lipoprotein That Increase Its Atherogenicity, N. Engl. J. Med. 320, 915–924.

    Article  PubMed  CAS  Google Scholar 

  38. Steinberg, D. (1991) Antioxidants and Atherosclerosis: A Current Assessment, Circulation 84, 1420–1425.

    PubMed  CAS  Google Scholar 

  39. Steinberg, D., and Workshop Participants (1992) Antioxidants in the Prevention of Human Atherosclerosis, Circulation 85, 2337–2344.

    PubMed  CAS  Google Scholar 

  40. Diaz, M.N., Frei, B., Vita, J.A., and Keaney, J.F. (1997) Antioxidants and Atherosclerotic Heart Disease, N. Engl. J. Med. 337, 408–416.

    Article  PubMed  CAS  Google Scholar 

  41. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group (1994) The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers in Male Smokers, N. Engl. J. Med. 330, 1029–1035.

    Article  Google Scholar 

  42. Stephens, N.G., Parsons, A., Schofield, P.M., Kelly, F., Cheeseman, K., and Mitchinson, M.J. (1996) Randomised Controlled Trial of Vitamin E in Patients with Coronary Disease: Cambridge Heart Antioxidant Study (CHAOS), Lancet 347, 781–786.

    Article  PubMed  CAS  Google Scholar 

  43. Mitchinson, M.J., Stephens, N.G., Parsons, A., Blight, E., Schoefield, P.M., and Brown, M.J. (1999) Mortality in the CHAOS Trial, Lancet 353, 381.

    Article  PubMed  CAS  Google Scholar 

  44. Ness, A., and Davey Smith, G. (1999) Mortality in the CHAOS Trial, Lancet 353, 1017–1018.

    Article  PubMed  CAS  Google Scholar 

  45. Brown, M. (1999) Do Vitamin E and Fish Oil Protect Against Ischaemic Heart Disease? Lancet 354, 441–442.

    Article  PubMed  CAS  Google Scholar 

  46. Rapola, J.M., Virtamo, J., Ripatti, S., Huttunen, J.K., Albanes, D., Taylor, P.R., and Heinonen, O.P. (1997) Randomised Trial of Alpha-Tocopherol and Beta-Carotene Supplements on Incidence of Major Coronary Events in Men with Previous Myocardial Infraction, Lancet 349, 1715–1720.

    Article  PubMed  CAS  Google Scholar 

  47. Omenn, G.S. (1995) What Accounts for the Association of Vegetables and Fruit with Lower Incidence of Cancers and Coronary Heart Disease? Ann. Epidemiol. 5, 333–335.

    Article  PubMed  CAS  Google Scholar 

  48. Rimm, E.B., Stampfer, M.J., Ascherio, A., Giovannucci, E., Colditz, G.A., and Willett, W.C. (1993) Vitamin E Consumption and the Risk of Coronary Heart Disease in Men, N. Engl. J. Med. 328, 1450–1456.

    Article  PubMed  CAS  Google Scholar 

  49. Stampfer, M.J., Hennekens, C.H., Manson, J.E., Colditz, G.A., Rosner, B., and Willett, W.C. (1993) Vitamin E Consumption and the Risk of Coronary Disease in Women, N. Engl. J. Med. 328, 1444–1449.

    Article  PubMed  CAS  Google Scholar 

  50. Kushi, L.H., Folsom, A.R., Prineas, R.J., Mink, P.J., Wu, Y., and Bostick, R.M. (1996) Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in Postmenopausal Women, N. Engl. J. Med. 334, 1156–1162.

    Article  PubMed  CAS  Google Scholar 

  51. Princen, H.M., van Duyvenvoorde, W., Buytenhek, R. van der Laarse, A., van Poppel, G., Gevers Leuven, J.A., and van Hinsbergh V.W. (1995) Supplementation with Low Doses of Vitamin E Protects LDL from Lipid Peroxidation in Men and Women, Arterioscler. Thromb. Vasc. Biol. 15, 325–333.

    PubMed  CAS  Google Scholar 

  52. Suzukawa, M., Ishikawa, T., Yoshida, H., and Nakamura, K. (1995) Effect of in-Vivo Supplementation with Low-Dose Vitamin E on Susceptibility of Low-Density Lipoprotein and High-Density Lipoprotein to Oxidative Modification, J. Am. Coll. Nutr. 14, 46–52.

    PubMed  CAS  Google Scholar 

  53. Weber, P., Bendich, A., and Machlin, L.J. (1997) Vitamin E and Human Health: Rationale for Determining Recommended Intake Levels, Nutrition 13, 450–460.

    Article  PubMed  CAS  Google Scholar 

  54. Porkkala-Sarataho, E.K., Nyyssonen, M.K., Kaikkonen, J.E., Poulsen, H.E., Hayn, E.M., Salonen, R.M., and Salonen, J.T. (1998) A Randomized, Single-Blind, Placebo-Controlled Trial of the Effects of 200 Mg α-Tocopherol on the Oxidation Resistance of Atherogenic Lipoproteins, Am. J. Clin. Nutr. 68, 1034–1041.

    PubMed  CAS  Google Scholar 

  55. De Waart, F.J., Moser, U., and Kok, F.J. (1997) Vitamin E Supplementation in Elderly Lowers the Oxidation Rate of Linoleic Acid in LDL, Atherosclerosis 133, 255–263.

    Article  PubMed  Google Scholar 

  56. Stampfer, M.J., Buring, J.E., Willett, W., Rosner, B., Eberlein, K., and Hennekens, C.H. (1985) The 2×2 Factorial Design: Its Applications to a Randomized Trial of Aspirin and Carotene in U.S. Physicians, Stat. Med. 4, 111–116.

    PubMed  CAS  Google Scholar 

  57. Byar, D.P., and Piantadosi, S. (1985) Factorial Designs for Randomized Clinical Trials, Cancer Treat. Rep. 69, 1055–1062.

    PubMed  CAS  Google Scholar 

  58. Marubini, E., and Valsecchi, M.G., eds.), (1995) Analysing Survival Data from Clinical Trials and Observational Studies, John Wiley, Chichester.

    Google Scholar 

  59. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of Cardiovascular Events and Death with Pravastatin in Patients with Coronary Heart Disease and a Broad Range of Initial Cholesterol Levels, N. Engl. J. Med. 339, 1349–1354.

  60. Pietinen, P., Ascherio, A., Korhonen, P., Hartman, A.M., Willett, W.C., Albanes, D., and Virtamo, J. (1997) Intake of Fatty Acids and Risk of Coronary Heart Disease in a Cohort of Finnish Men: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, Am. J. Epidemiol. 145, 876–887.

    PubMed  CAS  Google Scholar 

  61. Guallar, E., Aro, A., Jimenez, F.J., Martin-Moreno, J.M., Salminen, I., van't Veer, P., Kardinaal, A.F., Gomez-Aracena, J., Martin, B.C., Kohlmeier, L., et al. (1999) Omega-3 Fatty Acids in Adipose Tissue and Risk of Myocardial Infarction: The EURAMIC Study, Arterioscler, Thromb. Vasc. Biol. 19, 1111–1118.

    CAS  Google Scholar 

  62. Seidelin, K.N., Myrup, B., and Fischer-Hansen, B. (1992) n-3 Fatty Acids in Adipose Tissue and Coronary Heart Disease Are Inversely Related, Am. J. Clin. Nutr. 55, 1117–1119.

    PubMed  CAS  Google Scholar 

  63. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (1990) GISSI-2: A Factorial Randomised Trial of Alteplase Versus Streptokinase and Heparin Versus No Heparin Among 12,490 Patients with Acute Myocardial Infarction, Lancet 336, 65–71.

    Google Scholar 

  64. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI) (1994) GISSI-3: Effects of Lisinopril and Transdermal Glyceryl Trinitrate Singly and Together on 6-Week Mortality and Ventricular Function After Acute Myocardial Infarction, Lancet 343, 1115–1122.

    Google Scholar 

  65. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group (1995) ISIS-4: A Randomised Factorial Trial Assessing Early Oral Captopril, Oral Mononitrate, and Intravenous Magnesium Sulphate in 58,050 Patients with Suspected Acute Myocardial Infarction, Lancet 345, 669–685.

    Article  Google Scholar 

  66. Krauss, R.M., Eckel, R.H., Howard, B., Appel, L.J., Daniels, S.R., Deckelbaum, R.J., Erdman, J.W., Jr., Kris-Etherton, P., Goldberg, I.J., Kotchen, T.A., et al. (2000) AHA Dietary Guidelines Revision 2000: A Statement for Healthcare Professionals from the Nutrition Committee of the American Heart Association, Circulation 102, 2296–2311.

    Google Scholar 

  67. Marchioli, R., and Valagussa, F., on behalf of GISSI-Prevenzione Investigators (2000) The Results of the GISSI-Prevenzione Trial in the General Framework of Secondary Prevention, Eur. Heart J. 21, 949–952.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico, Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Italy

    Roberto Marchioli

  2. Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Santa Maria Imbaro (Chieti), Italy

    Roberto Marchioli

  3. Ospedale di Passirana di Rho, Milano, Italy

    Carlo Schweiger

  4. Policlinico San Matteo, Pavia, Italy

    Luigi Tavazzi

  5. Ospedale di Monza, Italy

    Franco Valagussa

Authors
  1. Roberto Marchioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlo Schweiger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luigi Tavazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Franco Valagussa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberto Marchioli.

About this article

Cite this article

Marchioli, R., Schweiger, C., Tavazzi, L. et al. Efficacy of n-3 polyunsaturated fatty acids after myocardial infarction: Results of GISSI-prevenzione trial. Lipids 36 (Suppl 1), S119–S126 (2001). https://doi.org/10.1007/s11745-001-0694-8

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11745-001-0694-8

Keywords

Search

Navigation