Dietary intake of n-3 long-chain polyunsaturated fatty acids and coronary events in Norwegian patients with coronary artery disease.
BACKGROUND
Consumption of fish and n-3 (omega-3) long-chain polyunsaturated fatty acids (LCPUFAs) has been associated with reduced risk of coronary artery disease (CAD) mortality.


OBJECTIVE
The aim was to examine the relation between dietary intake of n-3 LCPUFAs or fish and risk of future coronary events or mortality in patients with well-characterized CAD.


METHODS
This was a substudy of 2412 participants in the Western Norway B Vitamin Intervention Trial with a median follow-up time of 57 mo. Patients aged >18 y diagnosed with CAD (81% men) completed a food-frequency questionnaire at baseline, from which daily intakes of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids as well as fish were estimated on the basis of diet and intakes of supplements including fish and cod liver oils. The main endpoint was a composite of coronary events, including coronary death, nonfatal acute myocardial infarction, and unstable angina pectoris.


RESULTS
The mean (+/-SD) intakes of n-3 LCPUFAs in quartiles 1-4 were 0.58 +/- 0.29, 0.83 +/- 0.30, 1.36 +/- 0.44, and 2.64 +/- 1.18 g/d, respectively. We found no dose-response relation between quartiles of n-3 LCPUFAs (based on intake as percentage of total energy) or fish and coronary events or separate endpoints. A post hoc additive proportional hazards model showed a slightly increased risk of coronary events at an intake of n-3 LCPUFAs < approximately 0.30 g/d.


CONCLUSIONS
Among Norwegian patients with CAD consuming relatively high amounts of n-3 LCPUFAs and fish, there were no significant trends toward a reduced risk of coronary events or mortality with increasing intakes. This trial was registered at clinicaltrials.gov as NCT00354081.
Manger
Mari S
MS
Institute of Medicine, University of Bergen, Bergen, Norway.
Strand
Elin
E
Ebbing
Marta
M
Seifert
Reinhard
R
Refsum
Helga
H
Nordrehaug
Jan E
JE
Nilsen
Dennis W
DW
Drevon
Christian A
CA
Tell
Grethe S
GS
Bleie
Oyvind
O
Vollset
Stein E
SE
Pedersen
Eva R
ER
Nygård
Ottar
O
D000328:Adult; D000368:Aged; D000818:Animals; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D005227:Fatty Acids / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005247:Feeding Behavior; D005260:Female; D005399:Fishes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010743:Phospholipids / Q000097:blood; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D011795:Surveys and Questionnaires
D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D010743:Phospholipids