Influence of highly concentrated n-3 fatty acids on serum lipids and hemostatic variables in survivors of myocardial infarction receiving either oral anticoagulants or matching placebo

• Published in: Thrombosis research Vol. 53; no. 5; pp. 467 - 474
• Main Authors: Smith, P., Arnesen, H., Opstad, T., Dahl, K.H., Eritsland, J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Ltd 01.03.1989; Elsevier Science
• Subjects: Adult; Aged; Anticoagulants - therapeutic use; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Clinical Trials as Topic; Combined Modality Therapy; Coronary artery disease; Dietary Fats, Unsaturated - therapeutic use; Female; Fish Oils - therapeutic use; Hemostasis; Hemostasis - drug effects; Humans; Lipids - blood; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - diet therapy; Myocardial Infarction - drug therapy; Pharmacology. Drug treatments; Polyunsaturated fatty acids; Hemostasis; Polyunsaturated fatty acids; Coronary artery disease; Human; Infarct; Interaction; Oral administration; Cardiovascular disease; Lipids; Anticoagulant; Coronary heart disease; Chronic; Myocardium; Unsaturated fatty acid; Serum
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/0049-3848(89)90201-6

Forty patients with previous myocardial infarction were given 4 capsules with 1 g concentrated fish oil preparation daily for 4 weeks. No special diet was applied. The supplementation was equivalent to 3.4 grams of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) daily. Twenty-two of the 40 subjects received concomitant treatment with long-term oral anticoagulants (OAC). The fatty acid composition of serum after the supplementation period showed a significant increase in the proportion of EPA and DHA, while arachidonic acid (AA) remained essentially constant. This resulted in a rise of the EPA/AA ratio from 0.59 to 1.49 (p<0.001), confirming satisfying absorption of the concentrate. Blood lipids showed an overall decrease of triglycerides (TG) by 25% (p=0.02), while total cholesterol rose by 5% (p=0.03) and HDL-cholesterol was unaffected. Blood glucose and the TG associated factors plasminogen activator inhibitor and factor VII-phospholipid complex revealed trends towards reduction. Ivy bleeding time showed a significant prolongation, the median increasing from 240 to 270 seconds. A significant increase of fibrinogen was seen, as was a decrease of clotting time in the combined prothrombin test in patients receiving concomitant OAC. Thus, given for 4 weeks, the investigated concentrate of n-3 fatty acids exerts not merely beneficial effects as far as the risk profile for atherosclerotic disease is concerned. The results also point towards interactions with OAC that may be of clinical relevance.