Can omega-3 supplementation improve outcome in elderly following acute myocardial infarction?

Low levels of some omega-3 fatty acids can be linked to atrial fibrillation and heart failure in elderly with acute myocardial infarction.

In his main study, PhD candidate Kristian Laake aims to randomize 1400 elderly patients with myocardial infarction to either placebo or two years of supplementation with omega-3 fatty acids. The goal is to look at a combined endpoint of total mortality, first event of non-fatal myocardial infarction, stroke and revascularization.

The results published so far are based on the 299 first patients enrolled in the study. They were all between 70 and 82 years old at inclusion. Neither of the omega-3 fatty acids EPA or DHA, omega-6 fatty acids linoleic acid or arachidonic acid, nor the ratio of omega-6 to omega-3 fatty acids were associated with infarct size, measured as peak levels of troponin T at admission. However, low levels of some of the fatty acids were associated with increased odds of atrial fibrillation and higher levels of a marker for heart failure.

In a separate study, Laake has looked at whether supplementation with omega-3 fatty acids affects the levels of the inflammatory marker fractalkine in 563 elderly men with high cardiovascular risk. Three years of supplementation did not reduce the levels more than no supplementation, although reductions were seen in each of the four groups randomized to either omega-3 supplementation, Mediterranian-like dietary counseling, both, or placebo. Furthermore, the levels of fractalkine did not predict cardiovascular events or total mortality during the three-year follow-up.


THESIS DEFENCE

Thesis: Coronary heart disease and associations with omega-3 fatty acids in the elderly
Candidate:
 Kristian Laake
Time and place: March 24, 2017, Oslo University Hospital, Ullevål


REFERENCES

Laake, K., Myhre, P., Nordby, L. M., Seljeflot, I., Abdelnoor, M., Smith, P., Tveit, A., Arnesen, H., & Solheim, S. (2014). Effects of omega 3 supplementation in elderly patients with acute myocardial infarction: design of a prospective randomized placebo controlled study. BMC geriatrics, 14(1), 74.

Laake, K., Seljeflot, I., Fagerland, M. W., Njerve, I. U., Arnesen, H., & Solheim, S. (2015). Effects on serum fractalkine by diet and omega-3 fatty acid intervention: relation to clinical outcome. Mediators of inflammation, 2015.

Laake, K., Seljeflot, I., Schmidt, E. B., Myhre, P., Tveit, A., Arnesen, H., & Solheim, S. (2016). Serum Fatty Acids, Traditional Risk Factors, and Comorbidity as Related to Myocardial Injury in an Elderly Population with Acute Myocardial Infarction. Journal of lipids, 2016.

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