title: Early eicosapentaenoic acid treatment after percutaneous coronary intervention reduces acute inflammatory responses and ventricular arrhythmias in patients with acute myocardial infarction: a randomized, controlled study.
abstract: OBJECTIVE
  We examined whether early loading of eicosapentaenoic acid (EPA) reduces clinical adverse events by 1 month, accompanied by a decrease in C-reactive protein (CRP) values in patients with acute myocardial infarction (MI).
  
  
  BACKGROUND
  Acute MI triggers an inflammatory reaction, which plays an important role in myocardial injury. EPA could attenuate the inflammatory response.
  
  
  METHODS
  This prospective, open-label, blinded endpoint, randomized trial consisted of 115 patients with acute MI. They were randomly assigned to the EPA group (57 patients) and the control group (58 patients). After percutaneous coronary intervention (PCI), 1800 mg/day of EPA was initiated within 24h. The primary endpoint was composite events, including cardiac death, stroke, re-infarction, ventricular arrhythmias, and paroxysmal atrial fibrillation within 1 month.
  
  
  RESULTS
  Administration of EPA significantly reduced the primary endpoint within 1 month (10.5 vs 29.3%, p=0.01), especially the incidence of ventricular arrhythmias (7.0 vs 20.6%, p=0.03). Peak CRP values after PCI in the EPA group were significantly lower than those in the control group (median [interquartile range], 8.2 [5.6-10.2] mg/dl vs 9.7 [7.6-13.9] mg/dl, p<0.01). Logistic regression analysis showed that EPA use was an independent factor related to ventricular arrhythmia until 1 month, with an odds ratio of 0.29 (95% confidence interval, 0.09 to 0.96, p=0.04).
  
  
  CONCLUSIONS
  Early EPA treatment after PCI in the acute stage of MI reduces the incidence of ventricular arrhythmias, and lowers CRP values.
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: mdoimd@gmail.com.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Doi
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: kn_orch@yahoo.co.jp.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nosaka
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: miyoshit@cc.okayama-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Miyoshi
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: mutsum0808@yahoo.co.jp.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Iwamoto
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: kajiyanneko@yahoo.co.jp.
authors.forename: Masahito
authors.initials: M
authors.lastname: Kajiya
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: drop-in-bigriver@hotmail.co.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okawa
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: rie59828@yahoo.co.jp.
authors.forename: Rie
authors.initials: R
authors.lastname: Nakayama
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: t_wataru1206@yahoo.co.jp.
authors.forename: Wataru
authors.initials: W
authors.lastname: Takagi
authors.affiliation: Department of Cardiology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan. Electronic address: kou@chp-kagawa.jp.
authors.forename: Ko
authors.initials: K
authors.lastname: Takeda
authors.affiliation: International Center, 2-1-1 Tsushimanaka, Okayama 700-8530, Japan. Electronic address: hirohas@cc.okayama-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirohata
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: itomd@md.okayama-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000628:therapy*; D001145:Arrhythmias, Cardiac / Q000517:prevention & control*; D002097:C-Reactive Protein / Q000378:metabolism; D003131:Combined Modality Therapy; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D008297:Male; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid
keywords: Acute myocardial infarction; Arrhythmia; Complication; Eicosapentaenoic acid