Secondary prevention of coronary artery disease with omega-3 fatty acids
Secondary prevention of coronary artery disease with omega-3 fatty acids
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DOI：
10.1016/j.amjcard.2005.12.028
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发表时间：
2006-08-21
影响因子：
2.8
通讯作者：
Jacobson, Terry A.
中科院分区：
文献类型：
--
作者：
Jacobson, Terry A.
Omega-3 脂肪酸治疗是冠状动脉疾病 (CAD) 二级预防的一种有前途的干预措施。 Omega-3 脂肪酸具有促进动脉粥样硬化斑块稳定性并降低缺血引起的心律失常发生率的特性。在患有 CAD 或既往心肌梗塞 (MI) 的患者中进行的大量临床试验检查了硬心血管终点，包括总死亡率、心血管死亡率、猝死和非致命性 MI。几项中间心血管终点研究还检验了植入式心律转复除颤器 (ICD) 患者是否可以抑制室性心律失常。研究发现，使用 0.85 至 4.0 克/天的剂量，治疗持续时间为 12 至 42 个月，总死亡率和猝死显着降低（20% 至 50%）。一些（但不是全部）ICD 研究已经证明了心律失常事件发生率降低的有利趋势。 Omega-3 脂肪酸治疗在减少 MI 后以及患有缺血性心律失常的 ICD 患者中的危及生命事件方面显示出总体积极的趋势。最近日本 EPA 脂质干预研究 (JELIS) 对日本男性和女性的大型队列 (N = 18,645) 的结果表明，在减少不稳定心绞痛和非致命性冠状动脉事件方面具有显着的益处。全部证据都支持源自鱼油的 omega-3 脂肪酸通过假定的抗心律失常剂作用和促进斑块稳定的能力，在二级预防中发挥强大作用。 (c) 2006 Elsevier Inc. 保留所有权利。
Omega-3 fatty acid therapy is a promising intervention for the secondary prevention of coronary artery disease (CAD). Omega-3 fatty acids have properties that promote atherosclerotic plaque stability and decrease the, incidence of ischemia-driven cardiac arrhythmias. A large number of clinical trials conducted in patients with CAD or prior myocardial infarction (MI) have examined hard cardiovascular end points, including total mortality, cardiovascular mortality, sudden death, and nonfatal MI. Several intermediate cardiovascular end-point studies have also examined whether ventricular arrhythmias can be suppressed in patients with implantable cardioverter defibrillators (ICDs). Significant reductions in total mortality and sudden death-20% to 50%-have been found in studies using doses of 0.85 to 4.0 g/day, with treatment durations from 12 to 42 months. Favorable trends toward reduction in the incidence of arrhythmic events have been demonstrated in some, but not all, ICD studies. Omega-3 fatty acid therapy shows a general positive trend toward benefit in reducing life-threatening events after MI and in patients with ICDs who have ischemic arrhythmias. Results of the recent Japan EPA Lipid Intervention Study (JELIS) in a large cohort (N = 18,645) of Japanese men and women suggest significant benefits in the reduction of unstable angina and nonfatal coronary events. The totality of evidence supports a strong role for omega-3 fatty acids derived from fish oil in secondary prevention through a presumptive role as an antiarrhythmic agent and through an ability to promote plaque stabilization. (c) 2006 Elsevier Inc. All rights reserved.