Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial
Raitt MH, Connor WE, Morris C, Kron J, Halperin B, Chugh SS, McClelland J, Cook J, MacMurdy K, Swenson R, Connor SL, Gerhard G, Kraemer DF, Oseran D, Marchant C, Calhoun D, Shnider R, McAnulty J
JAMA · 226 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Center for Research Resources
- Gobierno
- NHLBI NIH HHS
- Gobierno
- NCRR NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (R01HL61682); National Center for Research Resources (5M01 RR00334)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2005-06-15 · JAMA · vol. 293 · número 23 · pág. 2884
- Editorial
- American Medical Association
- Citado
- 371 citas · más que el 100% de estudios similares · 36.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 25 trabajos
- Acceso
- De pago
- Áreas de investigación
- Fatty Acid Research and Health · Cardiac electrophysiology and arrhythmias · Cardiac pacing and defibrillation studies
- Palabras clave
- omega-3 polyunsaturated fatty acids, ventricular tachycardia, ventricular fibrillation, implantable cardioverter-defibrillator, antiarrhythmic effect, red blood cell membrane fatty acids, recurrent arrhythmia, sudden cardiac death, arrhythmia recurrence, omega-3 deficiency
- MeSH
- erythrocyte membrane, humans, tachycardia, ventricular, ventricular fibrillation, fatty acids, omega-3, proportional hazards models, risk, survival analysis, prospective studies, double-blind method, defibrillators, implantable, dietary supplements, aged, middle aged, female, male
18 autores
- Merritt H. Raitt🇺🇸 · autor de correspondenciaOregon Health & Science University
- William E. Connor🇺🇸Oregon Health & Science University
- Cynthia D. Morris🇺🇸Oregon Health & Science University
- Jack Kron🇺🇸Oregon Health & Science University
- Blair D. Halperin🇺🇸Providence St. Vincent Medical Center
- Sumeet S. Chugh🇺🇸Oregon Health & Science University
- James H. McClelland
- James Cook🇺🇸Tufts University
- Karen S. MacMurdy🇺🇸Oregon Health & Science University; Portland VA Medical Center
- Robert D. Swenson
- Sonja L. Connor🇺🇸Oregon Health & Science University
- Glenn T. Gerhard🇺🇸Oregon Health & Science University
- Dale F. Kraemer🇺🇸Oregon State University
- Daniel S. Oseran🇺🇸Providence St. Vincent Medical Center
- Christy Marchant🇺🇸Oregon Health & Science University
- David Calhoun🇺🇸Oregon Health & Science University
- Reed Shnider🇺🇸Tufts University
- John H. McAnulty🇺🇸Oregon Health & Science University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Context
Clinical studies of omega-3 polyunsaturated fatty acids (PUFAs) have shown a reduction in sudden cardiac death, suggesting that omega-3 PUFAs may have antiarrhythmic effects.
Objective
To determine whether omega-3 PUFAs have beneficial antiarrhythmic effects in patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF).
Design and setting
Randomized, double-blind, placebo-controlled trial performed at 6 US medical centers with enrollment from February 1999 until January 2003.
Patients
Two hundred patients with an implantable cardioverter defibrillator (ICD) and a recent episode of sustained VT or VF.
Intervention
Patients were randomly assigned to receive fish oil, 1.8 g/d, 72% omega-3 PUFAs, or placebo and were followed up for a median of 718 days (range, 20-828 days).
Main outcome measures
Time to first episode of ICD treatment for VT/VF, changes in red blood cell concentrations of omega-3 PUFAs, frequency of recurrent VT/VF events, and predetermined subgroup analyses.
Results
Patients randomized to receive fish oil had an increase in the mean percentage of omega-3 PUFAs in red blood cell membranes from 4.7% to 8.3% (P<.001), with no change observed in patients receiving placebo. At 6, 12, and 24 months, 46% (SE, 5%), 51% (5%), and 65% (5%) of patients randomized to receive fish oil had ICD therapy for VT/VF compared with 36% (5%), 41% (5%), and 59% (5%) for patients randomized to receive placebo (P = .19). In the subset of 133 patients whose qualifying arrhythmia was VT, 61% (SE, 6%), 66% (6%), and 79% (6%) of patients in the fish oil group had VT/VF at 6, 12, and 24 months compared with 37% (6%), 43% (6%), and 65% (6%) of patients in the control group (P = .007). Recurrent VT/VF events were more common in patients randomized to receive fish oil (P<.001).
Conclusion
Among patients with a recent episode of sustained ventricular arrhythmia and an ICD, fish oil supplementation does not reduce the risk of VT/VF and may be proarrhythmic in some patients.
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