Use of Fish Oils Appears to Reduce Infarct Size as Estimated from Peak Creatine Kinase and Lactate Dehydrogenase Activities

Abstract

In 753 patients with acute myocardial infarction, use of fish oils (FO, n = 242) before onset of infarction seemed to reduce infarct size as estimated from peak creatine kinase (CK_max) and lactate dehydrogenase (LD_max) activities. The study had an observational exposed/nonexposed design, and both crude and adjusted effects were looked for. Crude Effects: In the restricted cohort of patients not receiving thrombolytic treatment (n = 411), FO reduced CK_max from 879 to 759 U/l (2 p = 0.030) and LD_max from 870 to 768 U/l (2 p = 0.011), respectively. More of these patients in the lowest enzyme quartiles used FO, p for linear trend was for CK_max 0.008 and for LD_max 0.06, respectively. Adjusted Effects: In patients not receiving thrombolytic treatment, FO reduced CK_max (2 p = 0.007) and LD_max (2 p = 0.005), but in patients receiving such treatment, CK_max and LD_max values increased, 2 p being 0.036 and 0.097, respectively. In patients not receiving thrombolysis, FO increased the incidence of small infarcts (the 25% quartile), odds ratio for CK_max was 1.82 (2 p = 0.018) and for LD_max 1.66 (2 p = 0.048), respectively. The results indicate that FO may reduce infarct size and the incidence of large infarcts. In addition, FO seems to enhance the effect of thrombolysis.

Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease

“…Further evidence for a protective effect of omega-3 fatty acids comes from two recent studies by Landmark et al 24,25 who reported that chronic intake of fish or fish oil was associated with a reduction in infarct size as estimated by the frequency of Q-wave infarcts and by peak creatine kinase and lactate dehydrogenase activities after MI. In contrast to all the studies demonstrating a beneficial association, the AlphaTocopherol, Beta-Carotene Cancer Prevention Study found that estimated omega-3 fatty acid intake from fish was associated with a trend toward increased relative risk of coronary death after adjustment for trans, saturated, and cis-monounsaturated fatty acids.…”

Cardiovascular Effects of Omega-3 Free Fatty Acids.

“…In the US Physicians Health Study (21,000 males), the subjects consuming fish once or more per week had a 52% lower sudden death rate compared with subjects not consuming fish; the incidence of MI and non-sudden cardiac death was similar in the two groups [114]. In any case, the subjects consuming n-3 fatty acids at the moment of a MI presented lower scar extension and higher incidence of non-Q MI [115,116].…”

“…In any case, the analysis of several epidemiological observations and secondary prevention trials showed an association between n-3 fatty acid uptake and reduction of sudden death more than the reduction of non-fatal cardiovascular events [113][114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130].…”

New approaches to therapy with omega-3 fatty acids

“…In one prospective cohort study of 745 post-acute MI patients in Norway, peak serum creatine kinase levels (used as a surrogate for Q-wave infarction) correlated negatively with fish consumption [54].…”