April 22, 2021

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Zelniker reports that he was funded by a research grant from the German Research Foundation and received consultancy fees and fees from AstraZeneca and Boehringer Ingelheim. Please refer to the study for all relevant financial information from the other authors.

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In patients with ACS without ST segment elevation, a higher relative proportion of long-chain, polyunsaturated omega-3 fatty acids in plasma was associated with a lower chance of sudden cardiac death, the researchers reported.

Thomas A. Zelnik

“Although directional consistency across the omega-3 subtypes was observed, the magnitude of the effect appeared to be greatest with the long-chain marine polyunsaturated omega-3s, including docosahexaenoic acid, docosapentaenoic acid and eicosapentaenoic acid.” Thomas A. Zelniker, MD, MSc, Cardiologist at the Vienna General Hospital, Medical University of Vienna, and colleagues wrote.

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Zelniker and colleagues analyzed patients with non-ST segment elevation ACS (NSTEACS) from the MERLIN-TIMI 36 study to determine an association between the concentration of omega-3 polyunsaturated fatty acids in the plasma chain and cardiovascular outcomes . The cohort included 203 patients who died from a cardiovascular cause, 325 patients with MI, 271 patients with ventricular tachycardia, 161 patients with atrial fibrillation, and 1,612 controls with no events.

According to the researchers, patients with higher plasma levels of long-chain, polyunsaturated omega-3 fatty acids had an 18% lower chance of cardiovascular death after multivariable adjustment (OR = 0.82; 95% CI, 0.68-0.98) , mainly by a 27% lower probability of sudden cardiac death (OR = 0.73; 95% CI 0.55-0.97), while there was no significant association with cardiovascular death unrelated to sudden cardiac death.

When the cohort was stratified by quartiles based on the amount of long-chain, polyunsaturated omega-3 fatty acids in plasma, the higher the amount, the lower the likelihood of sudden cardiac death (P for trend = .025).

In the analysis, patients in the upper quartile of long-chain omega-3 polyunsaturated fatty acids in plasma had a 51% lower chance of cardiovascular death (OR = 0.49; 95% CI, 0.27-0.86) and a 63% lower chance of sudden cardiac death (OR = 0.37; 95% CI, 0.16-0.56) compared to those in the lower quartile.

According to the researchers, there was no significant relationship between alpha-linolenic acid levels and the subsequent likelihood of cardiovascular death (OR = 0.92; 95% CI 0.74-1.14) and sudden cardiac death (OR = 0.91; 95% CI 0.67 – 1.25).

Zelniker and colleagues also found no significant association between omega-3 polyunsaturated fatty acids and the likelihood of cardiovascular death unrelated to sudden cardiac death, MI, atrial fibrillation, or early ventricular tachycardia after ACS.

“These data support the theory that certain types of omega-3 supplementation may reduce the risk of adverse cardiovascular outcomes in higher risk populations,” the researchers wrote.

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