Article Text

Effect of ω-3 fatty acid supplementation on endothelial function, endogenous fibrinolysis and platelet activation in patients with a previous myocardial infarction: a randomised controlled trial
  1. Jehangir N Din1,
  2. Jaydeep Sarma2,
  3. Scott A Harding3,
  4. Karin Lyall1,
  5. David E Newby1,
  6. Andrew D Flapan4
  1. 1Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
  2. 2North West Heart Centre, Wythenshawe Hospital, Manchester, UK
  3. 3Department of Cardiology, Wellington Hospital, Wellington, New Zealand
  4. 4Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Jehangir N Din; jehangirdin{at}hotmail.com

Abstract

Objective The mechanisms through which ω-3 fatty acids reduce adverse cardiac events remain uncertain. We aimed to investigate the effect of ω-3 fatty acid supplementation on endothelial vasomotor function, endogenous fibrinolysis, and platelet and monocyte activation in patients with coronary heart disease.

Design Randomised, double-blind, placebo-controlled, cross-over trial.

Setting Academic cardiac centre.

Participants 20 male patients with a previous myocardial infarction.

Intervention ω-3 Fatty acid supplementation (2 g/day for 6 weeks) versus olive oil placebo.

Outcome measures Peripheral blood was taken for analysis of platelet and monocyte activation, and forearm blood flow (FBF) was assessed in a subset of 12 patients during intrabrachial infusions of acetylcholine, substance P and sodium nitroprusside. Stimulated plasma tissue plasminogen activator (t-PA) concentrations were measured during substance P infusion.

Results All vasodilators caused dose-dependent increases in FBF (p<0.0001). ω-3 Fatty acid supplementation did not affect endothelium-dependent vasodilation with acetylcholine and substance P compared with placebo (p=0.5 and 0.9). Substance P caused a dose-dependent increase in plasma t-PA concentrations (p<0.0001), which was not affected by ω-3 fatty acid supplementation (p=0.9). ω-3 Fatty acids did not affect platelet–monocyte aggregation, platelet P-selectin or CD40L, or monocyte CD40.

Conclusions We have demonstrated that dietary supplementation with ω-3 fatty acids does not affect endothelial vasomotor function, endothelial t-PA release, or platelet and monocyte activation in patients with coronary heart disease. Cardiac benefits conferred by ω-3 fatty acids in coronary heart disease are unlikely to be mediated through effects on these systems.

  • Nutrition & Dietetics
  • Vascular Medicine

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