Author + information
- Received July 21, 2009
- Revision received October 19, 2009
- Accepted November 2, 2009
- Published online April 20, 2010.
- Grzegorz Gajos, MD, PhD*,* (, )
- Pawel Rostoff, MD*,
- Anetta Undas, MD, PhD† and
- Wiesława Piwowarska, MD, PhD*,†
- ↵*Reprint requests and correspondence:
Dr. Grzegorz Gajos, Department of Coronary Disease, John Paul II Hospital, Pradnicka 80, Cracow 31-202, Poland
Objectives The purpose of this study was to investigate whether omega-3 polyunsaturated fatty acids (PUFAs) are able to modify platelet responsiveness to dual antiplatelet therapy in stable coronary artery disease patients undergoing percutaneous coronary intervention (PCI).
Background Although previous studies have suggested antiplatelet properties of omega-3 polyunsaturated fatty acids, it is unknown whether they can enhance platelet inhibition on standard aspirin and clopidogrel treatment.
Methods The OMEGA-PCI (OMEGA-3 Fatty Acids After PCI to Modify Responsiveness to Dual Antiplatelet Therapy) study was an investigator-initiated, prospective, single-center, double-blind, placebo-controlled, randomized study. Patients receiving standard dual antiplatelet therapy (aspirin 75 mg/day and clopidogrel 600 mg loading dose followed by 75 mg/day) were randomly assigned to receive the addition of 1 g of omega-3 ethyl esters (n = 33) or placebo (n = 30) for 1 month. Platelet function was measured serially by light transmission aggregometry (adenosine diphosphate and arachidonic acid [AA] were used as agonists) and assessment of the phosphorylation status of the vasodilator-stimulated phosphoprotein at baseline, 12 h, 3 to 5 days, and 30 days after randomization.
Results The P2Y12reactivity index was significantly lower, by 22.2%, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo when used in addition to dual antiplatelet therapy (p = 0.020). Maximal platelet aggregation induced by 5 and 20 μmol/l adenosine diphosphate was lower by 13.3% (p = 0.026) and 9.8% (p = 0.029), respectively, after 1 month of treatment with omega-3 polyunsaturated fatty acids compared with placebo. Platelet aggregation after AA stimulation was low and did not change significantly throughout the study. There were no cases of aspirin resistance during follow-up that was suggestive of good compliance with the medication.
Conclusions The addition of omega-3 ethyl esters to the combination of aspirin and clopidogrel significantly potentiates platelet response to clopidogrel after percutaneous coronary intervention.
This work was supported by the Ministry of Science and Higher Education of Poland(N402 095 31/2947to G.G.) and the Foundation “Helping the Heart” at the Department of Coronary Disease, Jagiellonian University School of Medicine (SKC1 to Dr. Gajos).
- Received July 21, 2009.
- Revision received October 19, 2009.
- Accepted November 2, 2009.
- American College of Cardiology Foundation