02 Aug Omega-3 fatty Acids May Reduce Cardiac Scarring After Heart Attack
MedicalResearch.com Interview with:
Raymond Y. Kwong, MD MPH
Director of Cardiac Magnetic Resonance Imaging
Associate Professor of Medicine
Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: In the past several decades, Omega-3 fatty acids (O3FA) primarily from fish oil have been reported to have many beneficial effects, either directly on the heart or through other effects that indirectly help the heart. However, when it was tested on patients who suffered an acute heart attack by looking at whether patients can live longer by taking omega-3 fatty acids early after the heart attack, there has been some conflicting data in some of the large clinical trials.
There are several major factors that inspired the designs of the current OMEGA-REMODEL study:
a) Over recent years, many highly effective treatments to improve the survival of heart attack victims have become routine.
b) The studies in the past used a relatively lower dose of Omega-3 fatty acids (1g per day).
c) Some have also raised the question whether just patient mortality should be the only/best way we should considered in assessing new treatments for heart attack patients.
d) Cardiac remodeling: after a heart attack, heart muscle not damaged by the initial heart attack insult has to overwork to compensate for the damage from the heart attack. Over time scarring may form in the overworked heart muscle, in addition to weakened heart function, may lead to the heart to fail.
e)New imaging method: a MRI of the heart, can precisely determine the heart function and the amount of scarring of the overworked heart muscle not damaged from the heart attack.
MedicalResearch.com: What are the main findings?
– Approximately 360 patients from 3 teaching hospitals in Boston were enrolled. All patients received all standard treatments based on clinical guidelines.
– We randomize ½ of the patients to receiving high dose (4 g per day for 6 months) of omega-3 fatty acids after the acute heart attack.
– Patients who received Omega-3 fatty acids , and specifically those who could absorb proportionally high amount of O3FA into their body, improved the function of the heart and also reduced scarring in the undamaged heart muscle. The amount of improvement in the heart appeared to be proportional to how much O3FA was incorporated into the body.
– On average, those who took O3FA had approximately a 6% both in improvement of the heart function and in reducing heart muscle scarring. Those who achieved the highest quartile of Omega-3 fatty acids increase had a 13% improvement in heart function. These numbers may sound small but these 360 patients were treated very well at these hospitals and majority of them received and could tolerate all the standard treatments we usually give heart attack patients, e.g. in the whole spectrum of heart attack patients they were not considered very sick, most with only a mildly weakened heart after the heart attack. So we believe that this observed benefit from Omega-3 fatty acids based on imaging can be clinically significant from Omega-3 fatty acids :
– None of the patients in the study experienced any major side effects from the O3FA.
– We also found that some of the blood biomarkers associated with inflammation of the body, were proportionally driven down by Omega-3 fatty acids .
– Therapies that can improve healing of the heart or prevent adverse remodeling by suppressing inflammation, remain very limited. There had been other drugs in the past that attempted to suppress inflammation after a HA and turned out to be harmful. So Omega-3 fatty acids if it continues to work as promising as our study shows, may offer a hopeful treatment option.
MedicalResearch.com: What should readers take away from your report?
Response: We believe this study highlights the benefits of high-dose Omega-3 fatty acids taken during the initial 6 months in heart attack patients: based on evidence from our study that directly visualized heart structures and functions.
While not directly the focus of our current study, we believe it is logical to infer that Omega-3 fatty acids may be a beneficial treatment that reduces incidence of patients’ heart failure or even mortality after a heart attack. More research studies are warranted in further assessing the impact on patient outcomes in large-scale trials, effects from other resembling preparations of Omega-3 fatty acids , and cellular mechanisms of O3FA on the heart.
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Bobak Heydari, Shuaib Abdullah, James V. Pottala, Ravi Shah, Siddique Abbasi, Damien Mandry, Sanjeev A. Francis, Heidi Lumish, Brian B. Ghoshhajra, Udo Hoffmann, Evan Appelbaum, Jiazhuo H. Feng, Ron Blankstein, Michael Steigner, Joseph P. McConnell, William Harris, Elliott M. Antman, Michael Jerosch-Herold, Raymond Y. Kwong. Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial InfarctionClinical Perspective. Circulation, 2016; 134 (5): 378 DOI: 10.1161/CIRCULATIONAHA.115.019949
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