Long-Term Effects of Omega-3 Polyunsaturated Fatty Acids on Coronary Heart Disease in Patients With Multivessel Stenotic Coronary Artery Atherosclerosis and St-Segment Elevation Myocardial Infarction: Post-Trial Analysis

Introduction. Many studies have shown a clear association between certain dietary fats and mortality. However, data on specific dietary fats and mortality among patients with cardiometabolic disease remain equivocal. Low-density lipoprotein cholesterol is considered an important target for the prevention and treatment of atherosclerotic cardiovascular disease. However, many patients still have residual cardiovascular risks even if low-density lipoprotein cholesterol reaches target levels. Recent evidence suggests that elevated triglycerides or triglyceride-rich lipoprotein cholesterol are an important component of residual cardiovascular risk. Omega-3 fatty acids have been an effective treatment for the reduction of triglycerides. The objective of this study was to evaluate the association between long-term omega-3 fatty acid intake and prognosis in patients with coronary heart disease in the context of multivessel coronary disease after myocardial infarction. Materials and Methods. The authors conducted post-trial follow-up of patients 5 years after the 12-month study on the efficacy and safety of ω-3 PUFAs in a dose of 1000 mg/day in the course of coronary heart disease with multivessel coronary disease after myocardial infarction. In retrospect, all patients who previously participated in the study were divided into three groups: Group 1 - patients who did not receive ω-3-PUFAs during the main study (information was obtained for 111 patients), Group 2 - patients who received ω-3-PUFAs during the study but did not receive (or received episodically) ω-3-PUFA during 5 years after the study (information was obtained for 61 such patients) and patients who received the study drug during the study and continued taking it continuously, with interruptions of only 2 weeks, during 5 years after the study (information on 32 patients was obtained). Results and discussion. After discontinuation of ω-3 PUFA for 5 years, its clinical efficacy registered after 12 months of continuous use was completely leveled, while the positive effect achieved after 12 months of observation in the case of continuation of ω-3 PUFA during the next 5 years not only did not disappear, but also had a cumulative character (P <0,02-0,03). The importance of long-term, preferably lifelong, ω-3-PUFAs at a dose of 1000 mg was established in the cohort of patients in the study. Conclusions. The results of the present study suggest that ω-3 PUFAs in 1000 mg may be associated with a lower all-cause mortality in patients with coronary heart disease against the background of multivessel coronary lesions after myocardial infarction.