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Effects of n-3 fatty acids on long-term outcomes of high risk patients with type 2 diabetes mellitus or IGF/IGT with a recent myocardial infarction.

Session Many risk factors - only one solution: prevention!

Speaker Aldo Pietro Maggioni

Event : ESC Congress 2013

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Abstract Session

Authors : A P Maggioni (Florence,IT), G Fabbri (Florence,IT), J Bosch (Hamilton,CA), L Dyal (Hamilton,CA), LE Ryden (Stockholm,SE), HC Gerstein (Hamilton,CA), S Yusuf (Hamilton,CA)

Authors:
A.P. Maggioni1 , G. Fabbri1 , J. Bosch2 , L. Dyal2 , L.E. Ryden3 , H.C. Gerstein2 , S. Yusuf2 , 1ANMCO Research Center - Florence - Italy , 2McMaster University and Population Health Research Institute - Hamilton - Canada , 3Karolinska University Hospital (Solna), Department of Cardiology - Stockholm - Sweden ,

On behalf: ORIGIN Investigators

Citation:
European Heart Journal ( 2013 ) 34 ( Abstract Supplement ), 352

Purpose: The ORIGIN trial showed that daily supplementation with 1 g of n–3 fatty acids did not reduce the rate of Cardiovascular (CV) events in high risk patients with type 2 Diabetes Mellitus (DM) or IFG/IGT. This ancillary analysis of the trial is aimed to evaluate the effect of this treatment in the subgroup of patients with a recent Myocardial Infarction (MI) in whom the use of n–3 fatty acids has been previously demonstrated to be able to prevent CV events in patients within 3 months of a MI.

Methods: The ORIGIN study randomly assigned patients to receive a 1g capsule containing at least 900 mg (90% or more) of ethyl esters of n–3 fatty acids or placebo daily. Long term outcomes were compared between n–3 fatty acids and placebo in the subgroup of patients with a recent MI (<6 months). Estimates of the hazard ratios and two-sided 95% confidence intervals were calculated with the use of a Cox regression model stratified according to study treatments, baseline metabolic status and a history of CV disease.

Results: Of the 12,536 patients entered in ORIGIN, 931 suffered a MI in the 6 months prior to randomization. Mean age was 62 years, female gender accounted for 23% of the cases. The incidences of the primary outcome of the study (CV death) and of other relevant CV event during a median follow-up period of 6.2 years are reported in the Table.

Conclusions: As in the overall population of the study of high risk patients with a recent diagnosis of DM or IGT/IGF, a daily supplementation with 1 g of n–3 fatty acids did not reduce the rate of CV events even in those with a recent MI.

OutcomeOmega 3 (n=439)Placebo (n=492)Adjusted HR (95% CI)
CV death, %11.810.01.19 (0.80–1.75)
All-cause death, %17.314.81.16 (0.84–1.60)
Non fatal MI, %8.79.10.95 (0.62–1.46)
Non fatal stroke, %2.14.30.47 (0.22–1.04)
CV death, MI, stroke, %19.820.30.96 (0.72–1.29)
All-cause death, MI, stroke, %25.125.20.98 (0.76–1.27)

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