Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers
Studies show that patients with elevated triglycerides and well-controlled LDL levels under statin therapy still have a significant residual risk of cardiovascular (CV) events. Despite many attempts to reduce triglycerides with different hypolipidemic drugs, no therapeutic option has given satisfact...
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| Format: | Article |
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MDPI AG
2021-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/11/2495 |
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| author | Marijana Tadic Carla Sala Guido Grassi Giuseppe Mancia Stefano Taddei Wolfgang Rottbauer Cesare Cuspidi |
| author_facet | Marijana Tadic Carla Sala Guido Grassi Giuseppe Mancia Stefano Taddei Wolfgang Rottbauer Cesare Cuspidi |
| author_sort | Marijana Tadic |
| collection | DOAJ |
| description | Studies show that patients with elevated triglycerides and well-controlled LDL levels under statin therapy still have a significant residual risk of cardiovascular (CV) events. Despite many attempts to reduce triglycerides with different hypolipidemic drugs, no therapeutic option has given satisfactory results so far. The initial enthusiasm that omega-3 fatty acids can effectively reduce triglycerides and CV risk was replaced with skepticism when the first large clinical trials failed to show any benefit in primary or secondary prevention. However, the latest studies succeeded in showing a positive effect of omega-3 fatty acids on CV outcome in patients with hypertriglyceridemia. The largest benefit was reported in secondary but not primary prevention. Interestingly, the reduction in triglycerides in some of these studies was disproportionately low to the relatively high CV risk reduction, which could indicate some other effects of omega-3 fatty acids that go well beyond hypotriglyceridemic action. This includes blood pressure reduction, antithrombotic effect, improvement of inflammatory status, endothelial function, and insulin resistance. Investigations also reported a significant and positive influence of omega-3 fatty acids on the composition and stabilization of coronary atherosclerotic plaques in patients with and without previous CV events. In addition to insufficiently known mechanisms of action and conflicting results about the effectiveness of omega-3 fatty acids, the safety problems, which include increased prevalence of atrial fibrillation and hemorrhage, were also reported. The aim of this clinical review was to summarize the current knowledge regarding the use of omega-3 fatty acids in CV patients, particularly those with coronary artery disease, and to present an overview of key clinical trial data. |
| first_indexed | 2024-03-10T10:42:14Z |
| format | Article |
| id | doaj.art-ab660f1894944fc6bd89f3969b556748 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:42:14Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ab660f1894944fc6bd89f3969b5567482023-11-21T22:53:21ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011011249510.3390/jcm10112495Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than AnswersMarijana Tadic0Carla Sala1Guido Grassi2Giuseppe Mancia3Stefano Taddei4Wolfgang Rottbauer5Cesare Cuspidi6Clinic for Internal Medicine II, Cardiology Department, University Clinic of Ulm, Albert-Einstein Allee 23, 89081 Ulm, GermanyDepartment of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di, 20126 Milan, ItalyClinica Medica, Cardiology Department, University of Milan-Bicocca, 20126 Milan, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan and Policlinico di Monza, 28100 Monza, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, ItalyClinic for Internal Medicine II, Cardiology Department, University Clinic of Ulm, Albert-Einstein Allee 23, 89081 Ulm, GermanyDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan and Policlinico di Monza, 28100 Monza, ItalyStudies show that patients with elevated triglycerides and well-controlled LDL levels under statin therapy still have a significant residual risk of cardiovascular (CV) events. Despite many attempts to reduce triglycerides with different hypolipidemic drugs, no therapeutic option has given satisfactory results so far. The initial enthusiasm that omega-3 fatty acids can effectively reduce triglycerides and CV risk was replaced with skepticism when the first large clinical trials failed to show any benefit in primary or secondary prevention. However, the latest studies succeeded in showing a positive effect of omega-3 fatty acids on CV outcome in patients with hypertriglyceridemia. The largest benefit was reported in secondary but not primary prevention. Interestingly, the reduction in triglycerides in some of these studies was disproportionately low to the relatively high CV risk reduction, which could indicate some other effects of omega-3 fatty acids that go well beyond hypotriglyceridemic action. This includes blood pressure reduction, antithrombotic effect, improvement of inflammatory status, endothelial function, and insulin resistance. Investigations also reported a significant and positive influence of omega-3 fatty acids on the composition and stabilization of coronary atherosclerotic plaques in patients with and without previous CV events. In addition to insufficiently known mechanisms of action and conflicting results about the effectiveness of omega-3 fatty acids, the safety problems, which include increased prevalence of atrial fibrillation and hemorrhage, were also reported. The aim of this clinical review was to summarize the current knowledge regarding the use of omega-3 fatty acids in CV patients, particularly those with coronary artery disease, and to present an overview of key clinical trial data.https://www.mdpi.com/2077-0383/10/11/2495omega-3 fatty acidscardiovascular outcomehypertriglyceridemia |
| spellingShingle | Marijana Tadic Carla Sala Guido Grassi Giuseppe Mancia Stefano Taddei Wolfgang Rottbauer Cesare Cuspidi Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers Journal of Clinical Medicine omega-3 fatty acids cardiovascular outcome hypertriglyceridemia |
| title | Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers |
| title_full | Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers |
| title_fullStr | Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers |
| title_full_unstemmed | Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers |
| title_short | Omega-3 Fatty Acids and Coronary Artery Disease: More Questions Than Answers |
| title_sort | omega 3 fatty acids and coronary artery disease more questions than answers |
| topic | omega-3 fatty acids cardiovascular outcome hypertriglyceridemia |
| url | https://www.mdpi.com/2077-0383/10/11/2495 |
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