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Earlier use of omega-3s after a heart attack cuts mortality, claim researchers

Prescribing omega-3 supplements within two weeks of a heart attack reduces the risk of death by almost a third, claim UK researchers.

Their study showed that very early administration of omega-3 fatty acid supplements was more effective at preventing a mortality than following NICE advice to prescribe them within three months.

They looked at 2,466 UK patients who were prescribed a 1g daily dose of omega-3 fatty acids for secondary prevention of an MI, and compared each case with four controls who had a MI but were not prescribed the supplements.

The prescription of omega-3 supplements within 90 days of a myocardial infarction (MI) significantly reduced the risk of mortality by 21%, compared with those patients not taking omega-3 supplements.

This mortality reduction increased to 32% if prescribed within 14 days, compared with those not taking omega-3 supplements.

NICE currently recommend that patients who have had an MI within three months should be offered a prescription for at least a 1g daily omega-3 supplement, licensed for secondary prevention post-MI.

Study lead Professor Craig Currie, professor of applied pharmacoepidemiology at Cardiff University, said: ‘Although we did not examine for dose effects, the timing of administration of n-3 fatty acid treatment seems relevant for optimising survival benefit in secondary prevention patients post-MI.

‘Very early administration after hospital admission of higher doses of the licensed n-3 fatty acids should be evaluated.’

The recent ORIGIN trial found no difference between patients taking omega-3 supplements and those taking a placebo in over 12,000 patients with high cardiovascular risk, but this trial did not look at the time of initiation.

Dr Kosta Manis, a GP in Bexley and cardiology lead for the Bexley Clinical Commissioning Group, thought socioeconomic differences might explain the results.

He said: ‘In their own summary, they recognise that there are socioeconomic differences within the groups. I wonder if the results would have been the same had the groups been balanced for socioeconomic parameters.’

Despite this, Dr Manis did advocate the use of omega-3 in post-MI patients.

‘If I had an MI, I would have taken omega-3, particularly if I did not like eating oily fish twice a week.’

Dr Rubin Minhas, clinical director of the BMJ Clinical Evidence Centre and a GP in Hoo, Kent, said: ‘GPs should consider the NICE guidelines and the prescription of omega-3 acids in post-MI patients.

‘This research should stimulate trials in other groups, such as diabetics, to establish benefit of early initiation.’


Reduction in mortality risk with omega-3

Initiation time                           Reduction in mortality risk

Within 90 days                                   21%

Within 14 days                                   32%

Source: Clinical Therapeutics, online 17 December