Randomized , Double-Blind, Placebo-Controlled Trial of Fish Oil & Mustard Oil in Patients with suspected Acute Myocardial Infarction: The Indian Experiment of Infarct Survival – 4.
Randomized , Double-Blind, Placebo-Controlled Trial of Fish Oil & Mustard Oil in Patients with suspected Acute Myocardial Infarction: The Indian Experiment of Infarct Survival – 4.
Year: 1997
Authors: R Singh, M Niaz, J Sharma, R Kumar, V Rastogi, M Moshiri.
Publication Name: Cardiovascular Drugs and Therapy.
Publication Details: Volume 11; Page 485.
Abstract:
EPA, DHA and ALA have been consistently shown to protect against mortality from coronary artery disease (CAD). A growing body of evidence also suggests that increasing consumption of n3 fatty acids may protect against restenosis and remodeling, total mortality, and cardiac event rate following acute myocardial infarction (AMI). The present study examines the effect of the n-3 fatty acids found in fish oil (EPA and DHA) and mustard oil (ALA) on rapid protection against ischemic damage and complications in patients with suspected acute myocardial infarction (AMI). Three hundred and sixty individuals participated in this one-year randomized, placebo-controlled study. Only patients diagnosed of suspected AMI at the Medical Hospital and Research Centre in Moradabad over a 30-month period, who were admitted within 24-hours of AMI symptoms, were eligible for the study. Patients were randomly allocated to either: Group A (n=122), who consumed fish oil capsules daily containing 1.08g EPA and 0.72g DHA/day; Group B (n=120), who consumed mustard oil capsules containing 2.9g ALA/day; or Group C (n=118), who consumed placebo capsules containing 100mg/d of aluminum hydroxide, which has been shown to provide no benefit to AMI patients. Treatments were administered approximately 18-hours following onset of symptoms of AMI in all three groups. In addition, all groups were advised to follow a low fat prudent diet. Clinical, electrocardiographic, radiologic, and laboratory data were obtained for all patients during initial hospitalization and at the end of the one-year study period. The extent of cardiac disease, rise in cardiac enzymes, and lipid peroxides were comparable among all three groups upon entry into the study. After one-year, total cardiac events were significantly less in the fish oil and mustard oil groups when compared to the placebo group (24.5% and 28% vs. 34.7%, respectively). Non-fatal infarctions were also significantly less in the fish oil and mustard oil groups versus the placebo group (13.0% and 15.0% vs. 25.4%, respectively). No significant reduction in total cardiac deaths was observed for the mustard oil group; however, the fish oil group had significantly less cardiac deaths when compared to the placebo group (11.4% versus 22.0%). Both the fish and mustard oil groups also showed a significant reduction in total cardiac arrhythmias, left ventricular enlargement, and angina pectoris when compared to the placebo group. Modest reduction in blood lipoproteins were observed in the two intervention groups, and therefore do not appear to be part of the benefit in these two groups. Finally, a significant reduction in diene conjugates was observed in both experimental groups indicating the beneficial effect of n3 fatty acids may in part be due to a reduction of oxidative stress. These findings suggest that the n-3 fatty acids ALA, EPA, and DHA may provide rapid protective effects in patients with AMI. In addition, early intervention with n3 fatty acids is important as previous studies using ALA rich oil (soybean oil) provided at a later date following AMI demonstrated little if no benefit. The authors conclude that the administration of n-3 fatty acids immediately following AMI may be a significant preventative strategy in subsequent cardiac events.
