Incremental effects of eicosapentaenoic acid on cardiovascular events in statin-treated patients with coronary artery disease.
BACKGROUND
Results from JELIS (Japan EPA Lipid Intervention Study) demonstrated the efficacy of pure eicosapentaenoic acid (EPA) in preventing coronary artery disease (CAD) in hypercholesterolemic patients under statin treatment. The present study examined in detail whether EPA is effective for the secondary prevention of CAD.


RESULTS
Patients with established CAD and a total cholesterol level > or =250 mg/dl were observed with a mean follow-up of 4.6 years. They were randomly assigned to receive either 1,800 mg of EPA + statin (EPA group) or statin alone (control group). The incidence of major coronary events (MCE) were compared in the 2 groups. The incidence of MCE was significantly lower in the EPA group (8.7% vs 10.7%, adjusted hazard ratio =0.77, 95% confidence interval (CI) 0.63-0.96, P=0.017, number needed to treat (NNT) =49). Among 1,050 patients with prior myocardial infarction (MI), the incidence of MCE in the EPA group (15.0%) was significantly lower than that in the control group (20.1%, adjusted hazard ratio =0.73, 95%CI 0.54-0.98, P=0.033, NNT =19).


CONCLUSIONS
EPA is effective for secondary prevention of CAD, especially in individuals with prior MI, and should be added to conventional treatment.
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Minamikogushi, Ube, Japan. masunori@yamaguchi-u.ac.jp
Masunori
M
Matsuzaki
Mitsuhiro
M
Yokoyama
Yasushi
Y
Saito
Hideki
H
Origasa
Yuichi
Y
Ishikawa
Shinichi
S
Oikawa
Jun
J
Sasaki
Hitoshi
H
Hishida
Hiroshige
H
Itakura
Toru
T
Kita
Akira
A
Kitabatake
Noriaki
N
Nakaya
Toshiie
T
Sakata
Kazuyuki
K
Shimada
Kunio
K
Shirato
Yuji
Y
Matsuzawa
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D015118:Eicosapentaenoic Acid