title: No effect of n-3 fatty acids supplementation on NT-proBNP after myocardial infarction: the Alpha Omega Trial.
abstract: BACKGROUND
  heart failure is a major risk factor for cardiovascular mortality, for which n-3 fatty acids may have beneficial effects. We examined the effect of marine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and plant-derived alpha-linolenic acid (ALA) on N-Terminal-pro Brain Natriuretic Peptide (NT-proBNP), a biomarker of heart failure.
  
  
  METHODS
  we randomly assigned 4837 post-myocardial infarction patients, aged 60-80 years (82% men), 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. In a random selection of 639 patients, NT-proBNP was determined both at baseline and at the end of follow-up. NT-proBNP was loge-transformed and analysed by type of treatment using analysis of covariance adjusting for baseline NT-proNBP.
  
  
  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 level NT-proBNP increased from 245 ng/l (95%-confidence interval [CI]: 207-290) to 294 ng/l (95%-CI: 244-352) after 40 months (p = 0.001). NT-proBNP levels were not affected by ALA (+8% versus placebo; 95%-CI: -8% to +25%; p = 0.34), EPA-DHA (+2% versus placebo; 95%-CI: -14% to +18%; p = 0.78), nor EPA-DHA plus ALA (+9% versus placebo; 95%-CI: -8% to +25%; p = 0.31) treatment.
  
  
  CONCLUSIONS
  supplementation with modest amounts of EPA-DHA, with or without ALA, did not have a significant effect on NT-proBNP levels in patients with a history of myocardial infarction.
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 Clinical Chemistry, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: van't Sant
authors.affiliation: Department of Clinical Chemistry, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
authors.forename: Eugenie F
authors.initials: EF
authors.lastname: Gemen
authors.affiliation: Department of Clinical Chemistry, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: Kusters
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; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis; D006801:Humans; D008297:Male; D008383:Margarine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000178:diet therapy*; D045283:Natriuretic Agents / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011897:Random Allocation
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D045283:Natriuretic Agents; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D008383:Margarine
keywords: NT-proBNP; alpha-linolenic acid; docosahexaenoic acid; eicosapentaenoic acid; n-3 Polyunsaturated fatty acids; randomized double-blind placebo-controlled trial