title: n-3 PUFAs in cardiovascular disease.
abstract: Many large, randomised clinical trials and some meta-analyses have shown that treatment with n-3 polyunsaturated fatty acids (n-3 PUFAs) is associated with consistent benefits on cardiovascular (CV) events, primarily due to a reduction of coronary and CV deaths in patients with coronary heart disease. At variance with such evidence, some clinical trials and meta-analyses showing a neutral effect of n-3 PUFAs have been recently published, raising concern about the consistency of the evidence on the CV benefits of n-3 PUFAs. Several methodological and clinical aspects of these recent trials deserve to be considered. Indeed, the low rate of events or the overoptimistic expectations of the benefit of n-3 PUFAs used for sample size calculation led to an inadequate statistical power of several studies. The improvement of background medical therapy, serum baseline levels of n-3 PUFAs, and different doses and/or treatment duration might have downplayed the benefit of n-3 PUFAs. Similarly to old drugs shown to be effective some years ago, it is possible that the benefits of treatment with n-3 PUFAs are not as great in a modern CV prevention strategy so rich in many effective drugs compared with past trials testing CV drugs when less effective therapies were available.
authors.affiliation: Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy. Electronic address: marchioli@negrisud.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marchioli
authors.affiliation: Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy; Coronary Care Unit, Cardiologic Department, 'S.Pio' Hospital Vasto, Chieti, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Levantesi
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000378:metabolism / Q000517:prevention & control; D002986:Clinical Trials as Topic / Q000379:methods; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans
chemical_list: D015525:Fatty Acids, Omega-3
keywords: Cardiovascular prevention; Coronary disease; Myocardial infarction; Review; n−3 PUFA; n−3 polyunsaturated fatty acids