WAGENINGEN, the Netherlands—Supplementing with low doses of heart-healthy omega-3s did not reduce the rates of major cardiovascular events among heart patients who were receiving state-of-the-art care, according to a new study from Dutch researchers (DOI: 10.1056/NEJMoa1003603). They found patients who had already suffered a heart attack and who were receiving anti-hypertensive, anti-thrombotic and lipid-modifying therapy did not experience benefits from eating margarine with a small amount of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) or alpha-linolenic acid (ALA).
The multicenter, double-blind, placebo-controlled study, funded by the Netherlands Heart Foundation and others, randomly assigned 4,837 patients, 60 through 80 years of age (78 percent men), who had had a myocardial infarction and were receiving state-of-the-art antihypertensive, antithrombotic, and lipid-modifying therapy to receive for 40 months one of four trial margarines: a margarine supplemented with a combination of EPA and DHA (with a targeted additional daily intake of 400 mg of EPA–DHA), a margarine supplemented with ALA (with a targeted additional daily intake of 2 g of ALA), a margarine supplemented with EPA–DHA and ALA, or a placebo margarine.
The patients consumed, on average, 18.8 g of margarine per day, which resulted in additional intakes of 226 mg of EPA combined with 150 mg of DHA, 1.9 g of ALA, or both, in the active-treatment groups. During the follow-up period, a major cardiovascular event occurred in 671 patients (13.9 percent). Neither EPA–DHA nor ALA reduced this primary end point (P=0.93 for EPA—DHA; P=0.20 for ALA). Researchers considered major cardiovascular events to be fatal and nonfatal cardiovascular events and cardiac interventions.
However, in a pre-specified subgroup of women, ALA, as compared with placebo and EPA–DHA alone, was associated with a reduction in the rate of major cardiovascular events that approached significance (P=0.07). The rate of adverse events did not differ significantly among the study groups.