Table 1.
The overview of the largest clinical trials about omega-3 fatty acids and cardiovascular outcome.
| Reference | Sample Size | Omega-3 Fatty Acid | Inclusion Criteria | Follow-Up Period (Years) | Main Findings |
|---|---|---|---|---|---|
| JELIS [33] | 18,645 | EPA | Patients with or without CAD (previous MI, PCI or confirmed angina pectoris) | 4.6 | EPA reduced all-cause mortality in secondary, but not in primary prevention. |
| ORIGIN [34] | 12,536 | n-3 fatty acids | Patients at high risk of CV events and with imapired fasting glucose, glucose intolerance or DM | 6.2 | No reduction in rate of CV events (non-fatal MI or stroke, death from CV cause or arrhythmia) among patients who received omega-3 fatty acids in patients at high CV risk in primary prevention. |
| ASCEND [35] | 15,480 | EPA + DHA | Patients older than 40 years with DM, but without CVD | 7.4 | No effect on CV events (non-fatal MI or stroke, transient ischemic attack, or vascular death, excluding confirmed intracranial hemorrhage) among patients who received omega-3 fatty acids. |
| VITAL [36] | 25,871 | EPA + DHA | Healthy subjects (men > 50 years and women > 55 years) | 5.3 | No effect on CV events (MI, stroke, CV death) among patients who received omega-3 fatty acids. |
| REDUCE-IT [6] | 8,179 | Icosapent ethyl | Patients with established CVD or DM on statin therapy with increased TG | 4.9 | The risk of ishemic events (CV death, MI, revascularization, unstable angina) was significantly lower in patients tretaed with icosapent ethyl. |
| EVAPORATE [7] | 80 | Icosapent ethyl | Patients with confirmed coronary artery stenosis, on statin therapy with elevated TG | 1.5 | Patients on icosapent ethyl therapy experienced a significant reduction in low-attenuation plaque volume and thickening of fibrotic cap, which stabilizes plaque and prevents its rupture. |
| STRENGTH [37] | 13,078 | EPA + DHA | Established CVD or high risk for CVD | 3.5 | No significant effect of omega-3 fatty acids on CV death, non-fatal MI and stroke, coronary revascularization, and unstable angina. |
CAD—coronary artery disease, CV—cardiovascular, CVD—cardiovascular disease, DHA—docosahexaenoic acid, DM—diabetes mellitus, EPA—eicosapentaenoic acid, MI—myocardial infarction, PCI—percutaneous coronary intervention.