Effects of supplementation with polyunsaturated fatty acids in patients with heart failure

Nodari, Savina; Triggiani, Marco; Manerba, Alessandra; Milesi, Giuseppe; Dei, Livio

doi:10.1007/s11739-011-0671-y

Cited by 8 publications

(3 citation statements)

References 82 publications

(70 reference statements)

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“…While recruitment was still ongoing, hospitalization for heart failure (HF) was added to the definition of MACE by protocol amendment. This modification was made due to increased focus on HF in the elderly, studies showing reduction in adverse left ventricular remodeling with n3-PUFA [19][20][21] , and potentially to increase statistical power of the trial. The primary safety outcome was serious bleeding, defined according to Bleeding Academic Research Consortium (BARC) criteria 22 .…”

Section: Discussionmentioning

confidence: 99%

Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction

et al. 2021

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Background: High intake of marine n-3 polyunsaturated fatty acids (PUFA) has been associated with reduced risk of cardiovascular events; however, this has not been confirmed in patients with a recent acute myocardial infarction (AMI). Elderly patients are at particularly increased cardiovascular risk after MI, but few trials address this group specifically. Omega-3 fatty acids hold the potential to reduce cardiovascular events with limited adverse effects in this vulnerable group. The hypothesis was that daily addition of 1.8g n-3 PUFA to standard of care secondary prophylaxis in elderly patients who have survived an AMI would reduce the risk of subsequent cardiovascular events during 2 years follow-up. Methods: The OMega-3 fatty acids in Elderly with Myocardial Infarction (OMEMI) trial is an investigator-initiated, multi-center, randomized clinical trial adding 1.8 g n-3 PUFA (930 mg EPA and 660 mg DHA) versus placebo (corn oil) daily to standard of care in 70-82 years old patients with recent (2-8 weeks) AMI. The primary endpoint was a composite of non-fatal AMI, unscheduled revascularization, stroke, all-cause death, heart failure hospitalization after two years. The secondary outcome was new atrial fibrillation. The safety outcome was major bleeding. Serum fatty acids were measured as biomarkers of adherence. Results: In total, 1,027 patients were randomized. Follow-up data were available for 1,014 patients who were included in the intention-to-treat analysis. Mean ± SD age was 75±3.6 years, 294 (29%) were female and mean triglycerides were 111.4±61.9 mg/dL. The primary endpoint occurred in 108 (21.4%) patients on n-3 PUFA vs 102 (20.0%) on placebo (HR 1.08 [95%CI 0.82-1.41], p=0.60). The secondary endpoint occurred in 28 (7.2%) patients on n-3 PUFA vs 15 (4.0%) on placebo (1.84 [0.98 -3.45], p=0.06). Median changes in EPA and DHA were +87% and +16% for n-3 PUFA vs -13% and -8% for placebo. Major bleeding occurred in 54 (10.7%) and 56 (11.0%) in the n-3 PUFA and placebo groups, respectively (p=0.87). Similar results were found in per-protocol analysis (n=893). Conclusions: We could not detect reduction in clinical events in our elderly patients with a recent AMI, treated with 1.8 g n-3 PUFAs daily for 2 years. Clinical Trial Registration: OMEMI Study; URL: https://clinicaltrials.gov Unique Identifier: NCT01841944

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Section: Discussionmentioning

confidence: 99%

Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction

et al. 2021

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“…It has been suggested that adults with cardiac problems might benefit from n -3 PUFA, as they prevent atrial fibrillation recurrence and increase left ventricle systolic function and functional capacity ( 68 , 69 ) . A dose-dependent benefit of n -3 PUFA, whereby a higher dose was more beneficial, was demonstrated in a small trial on patients with chronic heart failure ( 70 ) .…”

Section: Pufamentioning

confidence: 99%

Vitamin E function and requirements in relation to PUFA

Raederstorff¹,

Wyss²,

et al. 2015

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Vitamin E (α-tocopherol) is recognised as a key essential lipophilic antioxidant in humans protecting lipoproteins, PUFA, cellular and intra-cellular membranes from damage. The aim of this review was to evaluate the relevant published data about vitamin E requirements in relation to dietary PUFA intake. Evidence in animals and humans indicates a minimal basal requirement of 4–5 mg/d of RRR-α-tocopherol when the diet is very low in PUFA. The vitamin E requirement will increase with an increase in PUFA consumption and with the degree of unsaturation of the PUFA in the diet. The vitamin E requirement related to dietary linoleic acid, which is globally the major dietary PUFA in humans, was calculated to be 0·4–0·6 mg of RRR-α-tocopherol/g of linoleic acid. Animal studies show that for fatty acids with a higher degree of unsaturation, the vitamin E requirement increases almost linearly with the degree of unsaturation of the PUFA in the relative ratios of 0·3, 2, 3, 4, 5 and 6 for mono-, di-, tri-, tetra-, penta- and hexaenoic fatty acids, respectively. Assuming a typical intake of dietary PUFA, a vitamin E requirement ranging from 12 to 20 mg of RRR-α-tocopherol/d can be calculated. A number of guidelines recommend to increase PUFA intake as they have well-established health benefits. It will be prudent to assure an adequate vitamin E intake to match the increased PUFA intake, especially as vitamin E intake is already below recommendations in many populations worldwide.

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“…Supplementation with natural compounds is discussed as an alternative for CD treatment (Jelicks et al, 2011;Maldonado et al, 2021). Literature indicates that omega-3 has important effects over treatment for cardiovascular diseases, reducing the occurrence of fatal events and hospital admissions (Nodari et al, 2011). A single-center double-blind clinical trial (clinicaltrials.gov #NCT01863576) was performed to investigate the effect of omega-3 supplementation in CCC patients.…”

Section: Natural Compoundsmentioning

confidence: 99%

Clinical trials for Chagas disease: etiological and pathophysiological treatment

Gonzaga,

Ferreira,

Coelho

et al. 2023

Front. Microbiol.

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Chagas disease (CD) is caused by the flagellate protozoan Trypanosoma cruzi. It is endemic in Latin America. Nowadays around 6 million people are affected worldwide, and 75 million are still at risk. CD has two evolutive phases, acute and chronic. The acute phase is mostly asymptomatic, or presenting unspecific symptoms which makes it hard to diagnose. At the chronic phase, patients can stay in the indeterminate form or develop cardiac and/or digestive manifestations. The two trypanocide drugs available for the treatment of CD are benznidazole (BZ) and nifurtimox (NFX), introduced in the clinic more than five decades ago. WHO recommends treatment for patients at the acute phase, at risk of congenital infection, for immunosuppressed patients and children with chronic infection. A high cure rate is seen at the CD acute phase but better treatment schemes still need to be investigated for the chronic phase. There are some limitations within the use of the trypanocide drugs, with side effects occurring in about 40% of the patients, that can lead patients to interrupt treatment. In addition, patients with advanced heart problems should not be treated with BZ. This is a neglected disease, discovered 114 years ago that still has no drug effective for their chronic phase. Multiple social economic and cultural barriers influence CD research. The high cost of the development of new drugs, in addition to the low economical return, results in the lack of investment. More economic support is required from governments and pharmaceutical companies on the development of more research for CD treatment. Two approaches stand out: repositioning and combination of drugs, witch drastically decrease the cost of this process, when compared to the development of a new drug. Here we discuss the progress of the clinical trials for the etiological and pathophysiological treatment for CD. In summary, more studies are needed to propose a new drug for CD. Therefore, BZ is still the best option for CD. The trials in course should clarify more about new treatment regimens, but it is already possible to indicate that dosage and time of treatment need to be adjusted.

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Effects of supplementation with polyunsaturated fatty acids in patients with heart failure

Cited by 8 publications

References 82 publications

Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction

Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction

Vitamin E function and requirements in relation to PUFA

Clinical trials for Chagas disease: etiological and pathophysiological treatment

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