title: n-3 fatty acids, ventricular arrhythmia-related events, and fatal myocardial infarction in postmyocardial infarction patients with diabetes.
abstract: OBJECTIVE
  We carried out a secondary analysis in high-risk patients with a previous myocardial infarction (MI) and diabetes in the Alpha Omega Trial. We tested the hypothesis that in these patients an increased intake of the n-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and α-linolenic acid (ALA) will reduce the incidence of ventricular arrhythmias and fatal MI.
  
  
  METHODS
  A subgroup of 1,014 post-MI patients with diabetes aged 60-80 years was randomly allocated to receive one of four trial margarines, three with an additional amount of n-3 fatty acids and one placebo for 40 months. The end points were ventricular arrhythmia-related events and fatal MI. The data were analyzed according to the intention-to-treat principle, using multivariable Cox proportional hazards models.
  
  
  RESULTS
  The patients consumed on average 18.6 g of margarine per day, which resulted in an additional intake of 223 mg EPA plus 149 mg DHA and/or 1.9 g ALA in the active treatment groups. During follow-up, 29 patients developed a ventricular arrhythmia-related events and 27 had a fatal MI. Compared with placebo patients, the EPA-DHA plus ALA group experienced less ventricular arrhythmia-related events (hazard ratio 0.16; 95% CI 0.04-0.69). These n-3 fatty acids also reduced the combined end-point ventricular arrhythmia-related events and fatal MI (0.28; 0.11-0.71).
  
  
  CONCLUSIONS
  Our results suggest that low-dose supplementation of n-3 fatty acids exerts a protective effect against ventricular arrhythmia-related events in post-MI patients with diabetes.
authors: Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands. daan.kromhout@wur.nl
authors: Daan
authors: D
authors: Kromhout
authors: Johanna M
authors: JM
authors: Geleijnse
authors: Janette
authors: J
authors: de Goede
authors: Linda M
authors: LM
authors: Oude Griep
authors: Barbara J M
authors: BJ
authors: Mulder
authors: Menko-Jan
authors: MJ
authors: de Boer
authors: Jaap W
authors: JW
authors: Deckers
authors: Eric
authors: E
authors: Boersma
authors: Peter L
authors: PL
authors: Zock
authors: Erik J
authors: EJ
authors: Giltay
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000178:diet therapy / Q000517:prevention & control*; D048909:Diabetes Complications / Q000178:diet therapy / Q000517:prevention & control; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008383:Margarine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000178:diet therapy / Q000401:mortality / Q000517:prevention & control*; D016016:Proportional Hazards Models
chemical_list: D015525:Fatty Acids, Omega-3; D008383:Margarine