Omega-3 fatty acid found to help treat cardiovascular events
Cardiologists may one day have a new tool to help prevent heart attacks and strokes in some high-risk patients: a prescription drug that contains large doses of EPA, an omega-3 fatty acid contained in fish oil. A large clinical trial found that the drug, called Vascepa, sharply reduced the rate of cardiovascular events in people with a history of heart disease or Type 2 diabetes, according to results that were announced last week.
Relevance of findings
The findings were particularly relevant for people with high triglycerides, a type of fat in the blood that has been linked to an increased risk of heart disease. The new trial, called Reduce-IT, focussed on people whose cholesterol levels were well controlled with statins but whose triglyceride levels remained very high. Many cardiovascular experts were doubtful that adding fish oil on top of statins would produce much, if any, benefit because a number of smaller and less rigorous studies over the years had failed. But the new trial showed that statin-treated adults with elevated triglycerides who were prescribed high doses of the purified EPA had a 25% reduction in their relative risk of heart attacks, strokes and other cardiac events compared to a control group of patients who received a placebo. The intervention in this trial, which was sponsored by Amarin, was not the typical fish oil supplement that can be purchased at any supermarket or pharmacy. Vascepa is a prescription drug that contains highly purified EPA. Fish oil supplements, on the other hand, often contain a mixture of both EPA and DHA and in some cases other oils as well. EPA and DHA are similar but have slightly different effects. Both can lower triglycerides, for example, but DHA also tends to raise LDL cholesterol, the so-called bad kind associated with heart disease. The trial enrolled 8,179 adults and followed them on average for about five years. In addition to lowering cardiovascular events, the trial found that Vascepa was safe and well tolerated. Amarin announced the findings on Monday and is expected to present the full results and data at an annual American Heart Association conference in November.
Dr. Ethan Weiss, a cardiologist and associate professor at the University of California, San Francisco, who was not involved in the study, said that the findings confirm the role that high triglycerides play in heart disease but that they nonetheless came as a shock because so many earlier trials of fish oil found little or no benefits. He pointed to several caveats: he and others need to see all of the data, and the patient population that is likely to benefit from Vascepa is very specific. Diet and exercise can also lower triglycerides — especially very low carbohydrate diets — and whether the outcome on heart risk might be similar to the effect produced by Vascepa should be studied, he said.NY TIMES