Effect of purified omega-3 fatty acids on reducing left ventricular remodeling after acute myocardial infarction (OMEGA-REMODEL study): a double-blind randomized clinical trial)

Abstract

Background: Omega-3 fatty acid (PUFAs) may have a number of beneficial pleiotropic effects. One randomized trial demonstrated significant survival benefit for PUFAs following acute MI. Methods: We conducted a randomized, double-blinded, placebo controlled trial of PUFA supplementation post acute MI. 358 patients were randomized to PUFAs or matching placebo for 6 months with assessment by serial cardiac MRI. The primary endpoint was changes in left ventricular remodeling. Secondary outcomes included a) expansion of myocardial extracellular volume fraction (MECVF), b) infarct size and c) changes in systemic biomarkers. Results: Baseline characteristics were balanced. After 6 months, there was a significant difference in %change of LVESVI (Table 2) and MECVF (Table 2). In addition, the inflammatory biomarkers, CRP and myeloperoxidase, were substantially reduced in the PUFAs treated arm (Table 2). Finally, %reduction in ST2, a biomarker of myocardial fibrosis, was significantly greater in the PUFAs treated arm (Table 2) after 6 months. Adjusted multivariable analysis demonstrated an independent association for change in PUFAs levels with adverse LV remodeling. Conclusion: The results demonstrate significant reduction in LVESVI and MECVF for patients treated with high-dose PUFAs. PUFAs also significantly reduced systemic biomarkers of inflammation and fibrosis. These findings represent the first description of the effect of PUFAs on myocardial tissue phenotypes during convalescent phase post MI. (Table presented).