Previous Myocardial Infarction
Conditions
Brief summary
The mechanisms through which omega-3 fatty acids reduce adverse cardiac events remain uncertain. The aim of the study was to investigate the effect of omega-3 fatty acid supplementation on endothelial vasomotor function, endogenous fibrinolysis, and platelet and monocyte activation in patients with coronary heart disease.
Detailed description
Twenty patients with a previous myocardial infarction were recruited into a randomised, double-blind, placebo-controlled, crossover trial of omega-3 fatty acid supplementation (2g/day for 6-weeks). Peripheral blood was taken for analysis of platelet and monocyte activation, and forearm blood flow was assessed in a subset of 12 patients during intrabrachial infusions of acetylcholine, substance P and sodium nitroprusside. Stimulated plasma tissue plasminogen activator (t-PA) concentrations were measured during substance P infusion.
Interventions
DIETARY_SUPPLEMENTOmega 3 fatty acid supplementation
2 grams Omacor daily
DIETARY_SUPPLEMENTOlive Oil
2 grams olive oil daily
Sponsors
University of Edinburgh
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Myocardial infarction at least 3 months previously.
Exclusion criteria
* Dietary fish allergy or intolerance * Women of child bearing potential * Malignant arrhythmias * Renal or hepatic failure * Severe or significant co-morbidity * Previous history of blood dyscrasia * Unable to tolerate the supine position * Lack of informed consent * Blood donation within last 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Endogenous fibrinolysis (net release of plasma t-PA,IU mL-1) | Measured at 6 weeks after omega 3 fatty acids or placebo | Endogenous fibrinolysis was measured by drawing blood during intrabrachial substance P infusion and then plasma t-PA antigen and activity (t-PA Combi Actibind Elisa Kit; Technoclone, Vienna, Austria) concentrations were determined by enzyme-linked immunosorbent assays. Estimated net release of plasma t-PA was the product of the infused forearm plasma flow (based on the mean hematocrit and the infused forearm blood flow) and the concentration difference between the infused and noninfused arms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Endothelial vasomotor function (forearm blood flow, mL l00 mL-1 min-1) | Measured at 6 weeks after omega 3 fatty acids or placebo | Forearm blood flow was measured during intrabrachial infusions of acetylcholine, substance P and sodium nitroprusside by venous occlusion plethysmography with mercury-in-silicone elastomer strain gauges. |
| Circulating platelet-monocyte aggregates (%). | Measured at 6 weeks after omega 3 fatty acids or placebo | Whole blood was immunolabelled with appropriate monoclonal antibodies for subsequent flow cytometric analysis of platelet-monocyte aggregation. Platelet-monocyte aggregates were defined as the percentage of monocytes positive for CD42a. |
Countries
United Kingdom
Outcome results
None listed