Fish oil supplements for prevention of restenosis after coronary angioplasty

Kaul, Upendra; Sanghvi, Sanjeev; Bahl, Vinay K.; Dev, V.; Wasir, Harbans S.

doi:10.1016/0167-5273(92)90059-c

Cited by 60 publications

(35 citation statements)

References 25 publications

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“…A lower dose should be used since this seems more effective and fewer side effects are encountered. The two studies [92,94] added in the present paper do not basically alter such a recommendation. Moreover, two large scale trials, EMPAR and FORT are currently recruiting patients [97] and we can hopefully draw final conclusions after the results of these studies have been published.…”

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 77%

“…Angiography seems to be the most appropriate approach as restenosis is observed angiographically in 11-33% of patients without symptoms or with the negative exercise tests [95]. Coronary angiography was conducted in almost all patients in four studies [87,88,91,93] and selectively in four [89,90,92,94], while in the study by Slack et al [86] only exercise tests were evaluated. O'Connor and colleagues have recently performed a meta-analysis of seven [86][87][88][89][90][91]94] studies (see also Table 6) [96] and concluded that fish oil yields a small to moderate reduction in restenosis rate (6-46%).…”

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

“…Of the five studies without pretreatment two are negative [88,92], two [86,91] are positive and one [90] is positive based on clinical restenosis rate but negative when assessed by subsequent selective coronary angiography. On the other hand, two studies [89,94] are -3); FO, fish oil-treated group of patients; control, control group; none vessel disease; bmultivessel disease; ¢based on "intention to treat" principle; d%lesions/%lesions; e17% in aspirin/dipyridamole-treated patients.…”

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

“…Table 6 contains all restenosis studies [86][87][88][89][90][91][92][93][94] with fish oil published in the English literature. With the exception of the study by Bowles et al [92] all studies include a control group.…”

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

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Fish oil and the prevention and regression of atherosclerosis

Sassen

Lamers

Verdouw

1994

Cardiovasc Drug Ther

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Summary. Epidemiological studies in the seventies have put forward that dietary rather than genetic factors are responsible for the lower incidence of ischemic heart disease in Greenland Inuit and have generated a large body of both in vitro and in vivo experimental studies, exploring the putative favorable effects of fish (oil) on atherogenesis and its risk factors. The first part of this report reviews the in vivo animal studies, concentrating on the hypercholesterolemic models and the arterialized vein graft model. In the hypercholesterolemic animal studies, the results are inconclusive as the studies reporting a protective effect are matched by the number of studies showing no effect or an adverse effect. The diversity in species, dose of fish oil, duration of study, type of vessel studied and type of fish oil preparation (content of n-3 fatty acids, unesterified n-3 fatty acids, ethylesters or triglyceridcs) could all contribute. Furthermore, the definitions and criteria used in the literature to evaluate atherogenesis are diverse and it appears that while one parameter is affected, another is not necessarily modified in the same direction, stressing the importance of extending the analysis of the effects on atherogenesis to more than one parameter. We also believe that it is time to reach a consensus as to which animal model mimicks most closely a particular human situation. Only in appropriate models, investigating more than one atherosclerosis variable, can the effects of a putative anti-atherogenic drug or diet be verified. In the veno-arterial autograft model, mimicking the patient after coronary bypass grafting, dietary fish oil has been consistently effective in preventing accelerated graft intima proliferation. It could therefore be of interest to evaluate the effects of fish oil on graft patency in patients after coronary bypass surgery after a period of years.The results from studies on restenosis after percutaneous transluminal angioplasty are also reviewed and it is concluded that the two large scale trials, that are currently underway, might reliably answer the question whether fish oil is effective as a non-pharmacological adjuvants in the prevention of restenosis.Lastly, the studies on the effects of fish oil on the regression of experimental atherosclerosis are reviewed. In view of the small number of studies (i.e., four) investigating the effects of fish oil on the regression of atherosclerosis, it is premature to draw any conclusion, and therefore further experimental work is required.

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Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 77%

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

Section: Restenosis After Percutaneous Transluminal Coronary Angioplamentioning

confidence: 99%

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Fish oil and the prevention and regression of atherosclerosis

Sassen

Lamers

Verdouw

1994

Cardiovasc Drug Ther

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“…Control angiography 6 months after angioplasty in 109 patients showed a significant and clinically relevant reduction in the rate of restenosis in the fish-oil group (22%) as compared to the control group (40%). A study performed in India enrolled 107 patients, taking 3.0 g n-3 fatty acids, starting at a mean of 4 days before angioplasty [43]. No significant difference in the rate of restenosis during follow-up for at least 6 months was found.…”

Section: Cardiovascular Diseasementioning

confidence: 99%

n‐3 Polyunsaturated fatty acids: update 1995

Endres

Caterina

Schmidt

et al. 1995

Eur J Clin Investigation

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. Epidemiologic and biochemical studies have suggested an anti‐inflammatory effect of n‐3 fatty acids. Beneficial therapeutic effects reported from small patient groups need to be confirmed in large‐cohort controlled clinical trials. There is a growing number of clinical trials of n‐3 fatty acid supplementation in disease. Clinical benefits have been moderate in patients with rheumatoid arthritis and with arterial hypertension. Clearly negative results have been reported during the past 2 years for patients with lupus nephritis and for patients with psoriasis or with atopic dermatitis. Such trials have now been completed. For patients with coronary artery disease following coronary angioplasty, earlier results of a large meta‐analysis, could not be confirmed. For patients with IgA‐nephropathy and for patients following kidney transplantation, a clear benefit was seen in patients receiving fish oil. These promising results are currently pursued in follow‐up phase III clinical trials.

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