J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Editorial

Volume 6, Number 4, August 2016, pages 101-103

Which Is Better to Prevent Cardiovascular Events, Only EPA or the Combination of EPA and DHA?

Table

**Table 1.** Clinical Trials to Test the Effects of n-3 Fatty Acids (FA) on Cardiovascular Events
Trails	Subjects	Subjects who had taken statins (%)	EPA (mg/day)	DHA (mg/day)	Changes in TG	Endpoints	Risk reduction or increase by n-3 FA (P value)
JELIS [4]	Hypercholesterolemic patients (n = 18,645)	100	1800	0	Decrease by 9% in the EPA group and by 4% in control (P < 0.0001 between groups)	Sudden cardiac death, fatal and non-fatal myocardial infarction, unstable angina pectoris, angioplasty, stenting, or coronary artery bypass grafting	19% reduction (P = 0.011)
GISSI-P [5]	Patients surviving recent (≤ 3 months) myocardial infarction (n = 11,324)	4.7	464 - 482	386 - 400	Compared with controls (+1.4%), the small decrease in TG was significant in the n-3 FA group (-3.4%)	Death, non-fatal myocardial infarction, non-fatal stroke	10% reduction (P = 0.048)
GISSI-HF [6]	Patients with chronic heart failure (n = 6,975)	22.6	464 - 482	386 - 400	TG decreased slightly from a median value of 1.42 mmol/L at baseline to 1.36 mmol/L after 1 year and 1.34 mmol/L after 3 years, in the n-3 FA treatment group, but did not change in the placebo group	Death	9% reduction (P = 0.041)
GISSI-HF [6]	Patients with chronic heart failure (n = 6,975)	22.6	464 - 482	386 - 400		Death or admission to hospital for cardiovascular reasons	8% reduction (P = 0.009)
OMEGA [7]	Patients surviving acute (3 - 14 days) myocardial infarction (n = 3,851)	94.2	460	380	Small difference in favor of the n-3 FA group (n-3 FA group, 1.37 mmol/L (1.00 - 2.01 mmol/L); control group, 1.43 mmol/L (1.05 - 2.09 mmol/L); P < 0.01)	Sudden cardiac death	0% (P = 0.84)
						Total mortality	19.6% increase (P = 0.18)
						Major adverse cerebrovascular and cardiovascular events	15.4% increase (P = 0.1)
						Revascularization	5.4% reduction (P = 0.34)
ORIGIN [8]	Patients who were at high risk for cardiovascular events and had impaired fasting glucose, impaired glucose tolerance, or diabetes (n = 12,356)	53.8	465	375	The n-3 FA group showed a mean reduction in the TG of 14.5 mg/dL, as compared with the placebo group (P < 0.001)	Death from cardiovascular causes	2% reduction (P = 0.72)