EPA significantly reduces cardiovascular events

In 2018, a study found that a high dose of an omega-3 fatty acid given to patients at increased cardiac risk significantly reduced cardiovascular events.

Results from the reduction of cardiovascular events with the Icosapent Ethyl Intervention Trial (REDUCE-IT) were published in the New England Journal of Medicine. This helped the prescription drug Icosapent gain approval from the U.S. Food and Drug Administration, Health Canada, and the European Medicines Agency to reduce cardiovascular risk in those with elevated triglycerides. However, later studies of supplements that combine purified ethyl esters of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) had mixed results.

Deepak L Bhatt, Executive Director of Interventional Cardiovascular Programs in Brigham and lead investigator of the REDUCE-IT study, together with colleagues from the Harvard-affiliated Brigham and Women’s Hospital conducted a meta-analysis of 38 randomized clinical studies on omega-3 fatty acids through acids, including studies on EPA monotherapy and EPA + DHA therapy. These showed higher relative reductions in cardiovascular outcomes when only EPA was used.

“REDUCE-IT heralded a new era in cardiovascular prevention,” said Bhatt. “REDUCE-IT was the largest and most rigorous EPA study to date, but there were others. Now we can see that all of the evidence supports robust and consistent benefits from EPA. “

In total, these studies included more than 149,000 participants. They assessed key cardiovascular endpoints, including cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation. Overall, omega-3 fatty acids reduced cardiovascular mortality and improved cardiovascular outcomes.

The researchers find that there are crucial biological differences between EPA and DHA. Although both are considered omega-3 fatty acids, they have different chemical properties that affect their stability and the effect they can have on cholesterol molecules and cell membranes. To date, no studies have examined the effects of DHA alone on cardiovascular outcomes.

“This meta-analysis sheds light on the role of omega-3 fatty acids, especially prescription EPAs,” said Bhatt. “It should encourage researchers to further study the cardiovascular effects of EPA in different clinical settings.”

For more information on this research, see Meta-Analysis Finds Omega-3 Supplements Improve Cardiovascular Outcomes.

Reference: “Effect of Omega-3 Fatty Acids on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis” by Safi U. Khan, Ahmad N. Lone, Muhammad Shahzeb Khan, Salim S. Virani, Roger S. Blumenthal, Khurram Nasir, Michael Miller, Erin D. Michos, Christie M. Ballantyne, William E. Boden, and Deepak L. Bhatt, July 8, 2021, eClinical Medicine.
DOI: 10.1016 / j.eclinm.2021.100997

REDUCE-IT was sponsored by Amarin. Brigham and Women’s Hospital receives research funding from Amarin for the work Bhatt has done as a study director and as an international study director. The present analysis was not funded.

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