Author + information
- Received August 8, 1994
- Revision received February 3, 1995
- Accepted February 8, 1995
- Published online June 1, 1995.
- Frank M. Sacks, MD**,*,‡,
- Peter H. Stone, MD, FACC*,‡,
- C. Michael Gibson, MD, FACC*,†,‡,
- David I. Silverman, MD, FACC†,‡,
- Bernard Rosner, PhD*,‡,
- Richard C. Pasternak, MD, FACC†,‡,
- HARP Research Group
- ↵**Address for correspondence:Dr. Frank M. Sacks, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, Massachusetts, USA Q2115.
Objectives. This randomized clinical trial tested whether fish oil supplements can improve human coronary atherosclerosis.
Background. Epidemiologic studies of populations whose intake of oily fish is high, as well as laboratory studies of the effects of the polyunsaturated fatty acids in fish oil, support the hypothesis that fish oil is antiatherogenic.
Methods. Patients with angiographically documented coronary heart disease and normal plasma lipid levels were randomized to receive either fish oil capsules (n = 31), containing 6 g of n-3 fatty acids, or olive oil capsules (n = 28) for an average duration of 28 months. Coronary atherosclerosis on angiography was quantified by computer-assisted image analysis.
Results. Mean (±SD) baseline characteristics were age 62 ± 7 years, plasma total cholesterol concentration 187 ± 31 mg/dl (4.83 ± 0.80 mmol/liter) and triglyceride levels 132 ± 70 mg/dl (1.51 ± 0.80 mmol/liter). Fish oil lowered triglyceride levels by 30% (p = 0.007) but had no significant effects on other plasma lipoprotein levels. At the end of the trial, eicosapentaenoic acid in adipose tissue samples was 0.91% in the fish oil group compared with 0.20% in the control group (p < 0.0001). At baseline, the minimal lumen diameter of coronary artery lesions (n = 305) was 1.64 ± 0.76 mm, and percent narrowing was 48 ± 14%. Mean minimal diameter of atherosclerotic coronary arteries decreased by 0.104 and 0.138 mm in the fish oil and control groups, respectively (p = 0.6 between groups), and percent stenosis increased by 2.4% and 2.6%, respectively (p = 0.8). Confidence intervals exclude improvement by fish oil treatment of >0.17 mm, or >2.6%.
Conclusions. Fish oil treatment for 2 years does not promote major favorable changes in the diameter of atherosclerotic coronary arteries.
This study was supported by Grants RO1 HL36392 and NCRR-GCRC-RR02635 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland: by grants from Warner Lambert-Parke Davis, East Hanover, New Jersey; and by an Established Investigator Award to Dr. Sacks from the American Heart Association, Dallas, Texas.
- Received August 8, 1994.
- Revision received February 3, 1995.
- Accepted February 8, 1995.
- American College of Cardiology