James M. Brophy, MD, PhD
In patients with chronic heart failure (HF), does supplementation with n-3 polyunsaturated fatty acids (PUFAs) reduce morbidity and mortality?
Randomized placebo-controlled trial (Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico [GISSI]-HF trial). ClinicalTrials.gov NCT00336336.
Blinded (patients, clinicians, data collectors, outcome assessors, and outcome adjudication committee).*
Median 3.9 years.
326 cardiology and 31 internal medicine centers in Italy.
7046 patients ≥ 18 years of age (mean age 67 y, 78% men) with symptomatic HF of any cause (New York Heart Association class II to IV) treated with recommended pharmacologic therapies. Exclusion criteria included coronary heart disease event in the previous month, planned cardiac surgery, serious comorbid conditions, and significant liver disease.
n-3 PUFAs, 1 g daily (n = 3529), or placebo (n = 3517).
Time to death from any cause and a composite endpoint (time to death from any cause or hospitalization for cardiovascular reasons).
98% (intention-to-treat analysis).
Supplementation with n-3 PUFAs reduced risk for death and hospitalization for cardiovascular reasons (Table). Treatment effect was similar in patients subgrouped by age, left ventricular ejection fraction, HF cause or severity, presence of diabetes, or cholesterol level. 3% of patients in each group discontinued treatment because of adverse events, mainly gastrointestinal.
In patients with chronic heart failure, supplementation with n-3 polyunsaturated fatty acids reduced mortality and a composite endpoint of mortality or hospitalization for cardiovascular reasons.
n-3 polyunsaturated fatty acids (PUFAs) vs placebo for chronic heart failure†
†Abbreviations defined in Glossary. RRR, NNT, and CI calculated from hazard ratios in article, adjusted for hospitalization for heart failure in the previous year, previous pacemaker use, and aortic stenosis.
Brophy JM. n-3 polyunsaturated fatty acids reduced morbidity and mortality in chronic heart failure. Ann Intern Med. ;150:JC1–11. doi: 10.7326/0003-4819-150-2-200901200-02011
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Published: Ann Intern Med. 2009;150(2):JC1-11.
Cardiology, Coronary Risk Factors, Dyslipidemia, Heart Failure.
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