title: Eicosapentaenoic acid ethyl ester as an antithrombotic agent: comparison to an extract of fish oil.
abstract: Evidence suggesting that dietary omega-3 polyunsaturated fatty acids decrease the risk of thrombosis comes mainly from studies involving supplementation with large amounts (15-20 g/day) of fish oil extract. We investigated the inhibition of platelet function by a moderate amount (4 g/d) of ethyl eicosapentaenoate (E-EPA) compared to a concentrated fish oil extract (6 g/d) when given as a supplement to an ordinary diet. We also determined the effects of these supplements on platelet EPA incorporation, thromboxane synthesis, calcium mobilization and fibrinogen binding. After 4 weeks, both omega-3 supplements increased the amount of EPA in platelet phospholipids. The fish oil extract, which contained docosahexaenoic acid (DHA), had increased the amount of DHA also. The total increase in omega-3 fatty acids was similar for both supplements. E-EPA decreased serum cholesterol by 13% and triacylglycerols, 35%; increased the bleeding time by 57% and the threshold dose of collagen needed to induce platelet aggregation by 46%. Thromboxane synthesis in response to collagen was decreased 65% by E-EPA. Thus, the dietary supplement of pure E-EPA was more effective in limiting platelet reactivity than a concentrated fish oil extract providing an equivalent amount of omega-3 fatty acids. As an antithrombotic agent, E-EPA should allow for reasonable daily doses in long-term treatment of cardiovascular disease.
authors.affiliation: Cardeza Foundation for Hematologic Research, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107-5099.
authors.forename: C M
authors.initials: CM
authors.lastname: Wojenski
authors.forename: M J
authors.initials: MJ
authors.lastname: Silver
authors.forename: J
authors.initials: J
authors.lastname: Walker
mesh_terms: D000255:Adenosine Triphosphate / Q000097:blood; D000328:Adult; D001760:Bleeding Time; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D003094:Collagen / Q000494:pharmacology; D004041:Dietary Fats / Q000494:pharmacology*; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D005227:Fatty Acids / Q000032:analysis; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D005395:Fish Oils / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D010743:Phospholipids / Q000097:blood; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D010976:Platelet Count / Q000187:drug effects; D012016:Reference Values; D013931:Thromboxanes / Q000097:blood; D014280:Triglycerides / Q000097:blood
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids; D005343:Fibrinolytic Agents; D005395:Fish Oils; D010743:Phospholipids; D010975:Platelet Aggregation Inhibitors; D013931:Thromboxanes; D014280:Triglycerides; C035276:eicosapentaenoic acid ethyl ester; D000255:Adenosine Triphosphate; D003094:Collagen; D002784:Cholesterol; D015118:Eicosapentaenoic Acid