title: No effect of n-3 fatty acids on high-sensitivity C-reactive protein after myocardial infarction: the Alpha Omega Trial.
abstract: BACKGROUND
  Persistent inflammation plays a role in the pathogenesis of atherosclerosis. n-3 Fatty acids may have anti-inflammatory effects. This study examined the effect of plant-derived alpha-linolenic acid (ALA) and marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on high-sensitivity C-reactive protein (hsCRP), a systemic marker of (low-grade) inflammation.
  
  
  METHODS
  A supplementary study in the Alpha Omega Trial: a multicenter, double-blind, randomized, placebo-controlled trial of low-dose n-3 fatty acids. Patients were enrolled from 2002 to 2006 and followed for 40 months. A total of 2425 patients, aged 60-80 years (79% men), with a history of myocardial infarction, were randomly assigned to margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 40 months.
  
  
  RESULTS
  Patients consumed on average 19.8 g margarine/day, providing an additional amount of 238 mg/day EPA with 158 mg/day DHA, 1.98 g/day ALA, or both, in the active treatment groups. In the placebo group, the geometric mean hsCRP (95% confidence interval (CI)) was 1.84 mg/l (95% CI: +1.70 to +2.00) at baseline and 1.98 mg/l (95% CI: 1.82 to 2.15) after 40 months (p < 0.0001). hsCRP levels were not affected by ALA (-5% versus placebo; 95% CI: -14% to +6%, p = 0.37), EPA-DHA (-8% versus placebo; 95% CI: -17% to +2%, p = 0.13), or EPA-DHA plus ALA (-3% versus placebo; 95% CI: -12% to +8%, p = 0.62).
  
  
  CONCLUSIONS
  Long-term supplementation with modest amounts of EPA-DHA, whether or not in combination with ALA, did not affect hsCRP levels in patients with a history of myocardial infarction.
  NCT00127452.
authors.affiliation: Department of Internal Medicine and Nephrology, Jeroen Bosch Hospital, Den Bosch, The Netherlands ellen.hoogeveen@planet.nl.
authors.forename: Ellen K
authors.initials: EK
authors.lastname: Hoogeveen
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Geleijnse
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005527:Food, Fortified; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008383:Margarine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy*; D009426:Netherlands; D013997:Time Factors; D016896:Treatment Outcome; D017962:alpha-Linolenic Acid / Q000008:administration & dosage
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D018836:Inflammation Mediators; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D008383:Margarine; D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid
keywords: alpha-linolenic acid; docosahexaenoic acid; eicosapentaenoic acid; high-sensitivity C-reactive protein; n-3 Fatty acids; randomized double-blind placebo-controlled trial