Author + information
- Received February 5, 2009
- Accepted February 25, 2009
- Published online August 11, 2009.
- ↵⁎Reprint requests and correspondence:
Dr. Carl J. Lavie, Cardiac Rehabilitation, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, Louisiana 70121-2483
Omega-3 polyunsaturated fatty acid (ω-3 PUFA) therapy continues to show great promise in primary and, particularly in secondary prevention of cardiovascular (CV) diseases. The most compelling evidence for CV benefits of ω-3 PUFA comes from 4 controlled trials of nearly 40,000 participants randomized to receive eicosapentaenoic acid (EPA) with or without docosahexaenoic acid (DHA) in studies of patients in primary prevention, after myocardial infarction, and most recently, with heart failure (HF). We discuss the evidence from retrospective epidemiologic studies and from large randomized controlled trials showing the benefits of ω-3 PUFA, specifically EPA and DHA, in primary and secondary CV prevention and provide insight into potential mechanisms of these observed benefits. The target EPA + DHA consumption should be at least 500 mg/day for individuals without underlying overt CV disease and at least 800 to 1,000 mg/day for individuals with known coronary heart disease and HF. Further studies are needed to determine optimal dosing and the relative ratio of DHA and EPA ω-3 PUFA that provides maximal cardioprotection in those at risk of CV disease as well in the treatment of atherosclerotic, arrhythmic, and primary myocardial disorders.
Dr. Lavie has been a consultant and speaker for Reliant, Pfizer, Bristol-Myers Squibb, and Sanofi, and is a speaker receiving honorarium from and is on the Speakers' Bureau of GlaxoSmithKline, Abbott, and Solvay. Dr. Milani has served as a speaker receiving honorarium from and a consultant for Pfizer, AstraZeneca, Bristol-Myers Squibb, and Sanofi. Dr. Mehra has received research funding from the National Institutes of Health, Maryland Industrial Partnerships, and Orqis, and is a consultant for GlaxoSmithKline, Debio, Solvay, St. Jude, and Medtronic. Dr. Ventura is on the Speakers' Bureaus of Scios, GlaxoSmithKline, and AstraZeneca.
- Received February 5, 2009.
- Accepted February 25, 2009.
- American College of Cardiology Foundation
- Background Epidemiologic Evidence
- Trials in CHD
- Evidence of Benefit in Atherosclerosis
- Evidence in Arrhythmias
- Evidence of Benefit in HF
- Evidence for Benefit in Hyperlipidemia
- Additional Mechanisms and Optimal DHA/EPA Ratios
- Safety and Adverse Effects