EPA Added to Statin Therapy Reduces Risk For Major Coronary Events 
Author Message
 EPA Added to Statin Therapy Reduces Risk For Major Coronary Events

The Japanese randomized controlled clinical trial

Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y,
Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya
N, Sakata T, Shimada K, Shirato K; Japan EPA lipid intervention study
(JELIS) Investigators.
Effects of eicosapentaenoic acid on major coronary events in
hypercholesterolaemic patients (JELIS): a randomised open-label,
blinded endpoint analysis.
Lancet. 2007 Mar 31;369(9567):1090-8.
PMID: 17398308 [PubMed - in process]
< http://www.***.com/ ;
< http://www.***.com/ ;

found that taking 1800 mg of EPA daily with statin for 5 years reduced
major coronary events 19% in hypercholesterolaemic patients when
compared with statin only control group. The reduction was
statistically significant.

The abstract of the study:

    "Summary

    Background

    Epidemiological and clinical evidence suggests that an
    increased intake of long-chain n-3 fatty acids protects against
    mortality from coronary artery disease. We aimed to test the
    hypothesis that long-term use of eicosapentaenoic acid (EPA) is
    effective for prevention of major coronary events in
    hypercholesterolaemic patients in Japan who consume a large
    amount of fish.

    Methods

    18 645 patients with a total cholesterol of 6.5 mmol/L or
    greater were recruited from local physicians throughout Japan
    between 1996 and 1999. Patients were randomly assigned to
    receive either 1800 mg of EPA daily with statin (EPA group; n=
    9326) or statin only (controls; n=9319) with a 5-year follow-
    up. The primary endpoint was any major coronary event,
    including sudden cardiac death, fatal and non-fatal myocardial
    infarction, and other non-fatal events including unstable
    angina pectoris, angioplasty, stenting, or coronary artery
    bypass grafting. Analysis was by intention-to-treat. The study
    was registered at ClinicalTrials.gov, number NCT00231738.

    Findings

    At mean follow-up of 4.6 years, we detected the primary
    endpoint in 262 (2.8%) patients in the EPA group and 324 (3.5%)
    in controls - a 19% relative reduction in major coronary events
    (p=0.011). Post-treatment LDL cholesterol concentrations
    decreased 25%, from 4.7 mmol/L in both groups. Serum LDL
    cholesterol was not a significant factor in a reduction of risk
    for major coronary events. Unstable angina and non-fatal
    coronary events were also significantly reduced in the EPA
    group. Sudden cardiac death and coronary death did not differ
    between groups. In patients with a history of coronary artery
    disease who were given EPA treatment, major coronary events
    were reduced by 19% (secondary prevention subgroup: 158 [8.7%]
    in the EPA group vs 197 [10.7%] in the control group; p=0.048).
    In patients with no history of coronary artery disease, EPA
    treatment reduced major coronary events by 18%, but this
    finding was not significant (104 [1.4%] in the EPA group vs 127
    [1.7%] in the control group; p=0.132).

    Interpretation

    EPA is a promising treatment for prevention of major coronary
    events, and especially non-fatal coronary events, in Japanese
    hypercholesterolaemic patients."

Medscape's article

Fish Oil Added to Statin Therapy Reduces Risk For Major Coronary
Events  CME
News Author: Michael O'Riordan
CME Author: Dsire Lie, MD, MSEd
< http://www.***.com/ ;

comments this study. An excerpt:

    "April 3, 2007 - Results of the Japan EPA Lipid Intervention
    Study (JELIS), first presented at the American Heart
    Association's 2005 Scientific Sessions, have now been published
    in the March 31 issue of The Lancet. As previously reported by
    heartwire, the addition of eicosapentaenoic acid (EPA) to low-
    dose statin therapy significantly reduced the incidence of
    major coronary events, largely driven by a reduction in
    unstable angina, when compared with statins alone.

    A subgroup analysis of the study, which involved a large number
    of primary-prevention patients, revealed that statin-treated
    secondary-prevention patients gained the most benefit from
    fish-oil supplementation.

    The investigators, led by Mitsuhiro Yokoyama, MD, from Kobe
    University Graduate School of Medicine in Kobe, Japan, believe
    the benefit provided by the addition of EPA, a long-chain, n-3
    polyunsaturated fatty acid, to statin therapy does not appear
    to be mediated by the effects of cholesterol lowering. In both
    treatment groups, there was a 26% reduction in levels of low-
    density lipoprotein (LDL) cholesterol.

    "The beneficial effects of EPA could have stemmed from many
    biological effects that lead to the attenuation of thrombosis,
    inflammation, and arrhythmia, in addition to a reduction of
    triglycerides," write the authors. "Overall, this study shows
    that EPA, at a dose of 1800 mg per day, is a very promising
    regimen for prevention of major coronary events, especially
    since EPA seems to act through several biological mechanisms."

    In an accompanying editorial, Dariush Mozaffarian, MD, DrPH,
    from the Harvard Medical School in Boston, Massachusetts,
    commends the efforts of the JELIS investigators. He notes that
    the current study should inspire other clinical trials of the
    effects of fish oil and other dietary factors and habits on
    cardiovascular health. ..."

--
Matti Narkia



Mon, 21 Sep 2009 18:48:59 GMT
 EPA Added to Statin Therapy Reduces Risk For Major Coronary Events
Yes, they look at the "markers," but then ten years down the road,
what will the overall mortality be?  Fortunatetly for me, I had
relatives that lived to very old ages without {*filter*}.  They just
avoided the "essential fatty acids" and were fine, up to age 100 and
96.

My free site explains this, citing evidence and demonstrating why so
many of the "studies" the general public hears about seem to be more
like ads for the big pharmaceutical companies than anything else.
Most people don't realize how much evidence there is.  Last year,
there were about 10,000 studies just on "HIV/AIDS" alone.  How many of
those did you hear about in the media?  How does the media know which
ones are the most important?  Does the fact that the major evening
news shows on US television are sponsored by companies trying to sell
cholesterol-lowering medicaiton affect which studies the public hears
about?

Go to my site, forget the "news" - learn how to examine studies for
yourself:

http://www.***.com/

I'd suggest reading the essay on "Fish oil quotes you might want to
read" - I'll bet Mattia Narkia doesn't want you to know about this
information.



Tue, 22 Sep 2009 04:53:39 GMT
 
 [ 2 post ] 

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