New findings from the Alpha Omega Trial suggest that low-dose omega-3 fatty acid supplementation could play a role in preventing ventricular arrhythmia-related events in patients who have both diabetes and a history of myocardial infarction.
The trial was conducted by a team headed by Daan Kromhout, MPH, Ph.D., from the division of human nutrition at Wageningen University in the Netherlands. Kromhout and colleagues used a sample of 1,014 patients from the age of 60 to 80, who consumed margarine fortified with recommended daily doses of omega-3 fatty acids. Participants were randomly assigned to three groups, which consumed either placebo or one of three types of margarine fortified with omega-3 fatty acids: 400mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); 2g alpha-linolenic acid (ALA); or a combination of EPA, DHA, and ALA. All patients had a history of myocardial infarction within the past ten years. The trial was conducted over a period of 40 months.
Patients across all the groups consumed an average of 18.6g margarine daily, which included an average additional intake of 223mg EPA, 149mg DHA and 1.9g ALA. The median follow-up period was 40.7 months; during that time, 29 patients experienced a ventricular arrhythmia-related event. Another 27 died of myocardial infarction. According to the researchers, their data suggested that supplementation with omega-3 fatty acids in any combination reduced the patients’ chances of ventricular arrhythmia-related events when compared to the rates associated with placebo. Patients who received a combination of EPA, DHA and ALA supplementation had the lowest incidence at 84 percent less than with placebo. Supplementation with EPA, DHA, and ALA had similar benefits over placebo in reducing cardiac arrest, sudden death, and the placement of cardioverter defibrillators.
The groups receiving supplementation did not appear to differ significantly in rates of fatal myocardial infarction compared to the placebo group. However, after adjusting for potential confounding factors, the researchers found that the group receiving a combination of EPA, DHA and ALA saw a reduced endpoint for ventricular arrhythmia-related events as well as fatal myocardial infarction.
Kromhout pointed out in a press release that, although the findings suggest omega-3 fatty acid supplementation has benefits for patients with both diabetes and a history of myocardial infarction, additional research will need to be conducted before the mechanism underlying the benefits is understood.
“While more research is needed to definitively determine the role of these fatty acids in protecting people from ventricular arrhythmias, they seem to provide a benefit to the heart attack patients who also had diabetes,” said Kromhout. “This is the first study that showed a significant protective effect of omega-3 fatty acids in high-risk patients with diabetes who were on state-of-the-art drug treatment for their heart attack,” he continued.
Myocardial infarction, more commonly known as heart attack, is more common among patients with diabetes and is more fatal. Although the processes that cause heart attack are not different among diabetes patients, scientists believe that the procoagulant and prothrombotic characteristics of diabetes are responsible for the increased rates of heart attack. It is also more difficult to ensure proper blood flow through blood vessels in patients who have diabetes after heart attack than in patients without the metabolic disease. Among patients experiencing myocardial infarction, 10 to 30 percent have Type 2 diabetes. Rates of heart attack are expected to rise in the future along with the increasing rate of Type 2 diabetes.
