omacor and Death--Sudden--Cardiac

Patients treated with haemodialysis are at high risk of sudden cardiac death (SCD) often caused by arrhythmias. Atrial fibrillation (AF) is frequent among haemodialysis patients and is associated with increased mortality. Prolonged QTc is a risk marker of ventricular arrhythmia and is thereby associated with SCD. Studies have suggested that n-3 PUFA may have an antiarrhythmic effect, but the exact mechanism is not clear. The aim of this study was to examine whether AF was associated with n-3 PUFA in plasma phospholipids and whether supplementation with n-3 PUFA would shorten the QTc interval in haemodialysis patients compared to placebo. In a double-blinded randomised, placebo-controlled intervention trial 206 haemodialysis patients with CVD were treated with 1·7 g n-3 PUFA or placebo (olive oil) daily for 3 months. Blood samples and electrocardiogram evaluations were carried out at baseline and after 3 months. The QT interval, PQ interval and heart rate were measured in all patients with sinus rhythm (SR). At baseline 13 % of patients had AF. The content of the n-3 PUFA, DHA, was significantly lower (P < 0·05) in serum of patients with AF compared with patients with SR. Thus, the DHA content was independently negatively associated with AF. Supplementation with n-3 PUFA did not shorten the QT interval significantly compared to the placebo group (P = 0·42), although subgroup analysis within the n-3 PUFA group revealed a shortening effects on QTc (P = 0·01). In conclusion, an inverse association was found between the presence of AF and the plasma DHA in haemodialysis patients. Intervention with n-3 PUFA did not shorten the QTc interval compared to placebo.

Topics: Aged; Aged, 80 and over; Atrial Fibrillation; Cardiovascular Diseases; Cross-Sectional Studies; Death, Sudden, Cardiac; Denmark; Dietary Supplements; Docosahexaenoic Acids; Double-Blind Method; Drug Combinations; Eicosapentaenoic Acid; Female; Humans; Kidney Failure, Chronic; Long QT Syndrome; Male; Middle Aged; Phospholipids; Prevalence; Renal Dialysis; Risk Factors

During the last decades a large body of data has been accumulated indicating omega-3 fatty acids to exert beneficial effects on the prognosis of patients with cardiovascular disease. Especially, omega-3 fatty acids are regarded to be effective in reducing the risk of sudden cardiac death after acute myocardial infarction. However, treatment of acute myocardial infarction and secondary prevention considerably have been improved within the past years including early revascularization by PCI, the routine use of beta-blockers, statins and ACE-inhibitors as well as cardiac rehabilitation for improving life style measures. To date, there exists no controlled randomized trial testing the prognostic effect of omega-3 fatty acids after acute myocardial infarction in a double blind regimen under the conditions of modern treatment of myocardial infarction.. The present study therefore evaluates the effect of highly purified omega-3 fatty acid ethylesters (omega-3-acid ethyl esters 90=Zodin) on the rate of sudden cardiac death within 1 year after acute myocardial infarction. Secondary endpoints are total mortality, non-fatal cardiovascular events, rhythm abnormalities in holter monitoring and depression score.. The recruitment-period started in October 2003 and is expected to last until December 2006. The results of the study are therefore expected for the beginning of 2008, when all patients will have completed the 12-months follow up-period.

Topics: Death, Sudden, Cardiac; Depression; Double-Blind Method; Electrocardiography, Ambulatory; Fatty Acids, Omega-3; Female; Heart; Heart Rate; Humans; Male; Myocardial Infarction

Topics: Death, Sudden, Cardiac; Dose-Response Relationship, Drug; Drug Administration Schedule; Fatty Acids, Omega-3; Humans; Hypertriglyceridemia; Myocardial Infarction; Secondary Prevention; Survival Rate

Topics: Cause of Death; Clinical Trials as Topic; Cross-Sectional Studies; Death, Sudden, Cardiac; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Female; Humans; Male; Risk Factors

Topics: Clinical Trials as Topic; Death, Sudden, Cardiac; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Follow-Up Studies; Humans; Myocardial Infarction; Placebos; Risk Factors; Time Factors