title: Omega-3 Fatty Acids, Depressive Symptoms, and Cognitive Performance in Patients With Coronary Artery Disease: Analyses From a Randomized, Double-Blind, Placebo-Controlled Trial.
abstract: This trial investigated the efficacy of omega-3 polyunsaturated fatty acid (n-3 PUFA) treatment for improving depressive symptoms and cognitive performance in patients with coronary artery disease (CAD) participating in cardiac rehabilitation. Patients with CAD aged 45 to 80 years were randomized to receive either 1.9-g/d n-3 PUFA treatment or placebo for 12 weeks. Depressive symptoms were measured using the Hamilton Depression Rating Scale (HAM-D, primary outcome) and the Beck Depression Inventory II (BDI-II). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were used to identify a depressive episode at baseline. Cognitive performance was measured using a standardized battery for vascular cognitive impairment. In 92 patients (age, 61.7 ± 8.7 y; 76% male, 40% depressed; HAM-D, 6.9 ± 5.9; BDI-II, 12.3 ± 10.9; n = 45 n-3 PUFA, n = 47 placebo), depression decreased (HAM-D, F3,91 = 2.71 and P = 0.049; BDI-II, F3,91 = 6.24 and P < 0.01), and cognitive performance improved (attention/processing speed, F1,91 = 5.57, P = 0.02; executive function, F1,91 = 14.64, P < 0.01; visuospatial memory, F1,91 = 4.01, P = 0.04) over cardiac rehabilitation. Omega-3 PUFA treatment increased plasma eicosapentaenoic acid (F1,29 = 33.29, P < 0.01) and docosahexaenoic acid (F1,29 = 15.29, P < 0.01) concentrations but did not reduce HAM-D (F3,91 = 1.59, P = 0.20) or BDI-II (F3,91 = 0.46, P = 0.50) scores compared with placebo. Treatment did not improve cognitive performance; however, n-3 PUFAs significantly increased verbal memory compared with placebo in a subgroup of nondepressed patients (F1,54 = 4.16, P = 0.04). This trial suggests that n-3 PUFAs do not improve depressive and associated cognitive symptoms in those with CAD. The possible benefits of n-3 PUFAs for verbal memory may warrant investigation in well-powered studies.
authors.affiliation: From the *Hurvitz Brain Sciences Program, Sunnybrook Research Institute; Departments of †Pharmacology and Toxicology and ‡Psychiatry, University of Toronto; and §University Health Network at Toronto Rehabilitation Institute, Toronto; ∥Department of Human Health and Nutritional Sciences, University of Guelph, Guelph; and ¶Trillium Health Partners, Toronto, Ontario, Canada.
authors.forename: Graham
authors.initials: G
authors.lastname: Mazereeuw
authors.forename: Nathan
authors.initials: N
authors.lastname: Herrmann
authors.forename: Paul I
authors.initials: PI
authors.lastname: Oh
authors.forename: David W L
authors.initials: DW
authors.lastname: Ma
authors.forename: Cheng Tao
authors.initials: CT
authors.lastname: Wang
authors.forename: Alexander
authors.initials: A
authors.lastname: Kiss
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lanctôt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000188:drug therapy* / Q000209:etiology; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care
chemical_list: D015525:Fatty Acids, Omega-3