Fish Oil Sinks Coronary Event Rates When Added to Statins

KOBE, Japan, March 30 -- Fish-oil supplements added to statin therapy can further reduce the risk of major coronary events, even among patients who already eat a diet heavy in fish, investigators here reported.
Among more than 18,000 patients with hypercholesterolemia and a history of coronary artery disease, the addition to statins of eicosapentaenoic acid, a long-chain-n-3 fatty acid in fish oil, reduced the occurrence of major coronary events by 19% over statins alone, reported Mitsuhiro Yokoyama, M.D., from Kobe University here, and colleagues.
Eicosapentaenoic acid, (EPA) was associated with significant reductions in unstable angina and non-fatal coronary events, but there were no differences in either sudden cardiac death or coronary death, the investigators in the Japan EPA Lipid Intervention Study (JELIS).wrote in the March 31 issue of The Lancet.
In an accompanying editorial, Dariush Mozaffarian, M.D., Dr.P.H., of the Harvard School of Public Health commented that the findings lack the flash of clinical trial results on blockbuster drugs, but they show that a low-risk and inexpensive intervention could have a major effect on health
"We must curb our infatuation with downstream risk factors and treatments, and focus on the fundamental risk factors for cardiovascular disease: dietary habits, smoking, and physical activity," he wrote. "If the millions of heart attacks occurring each year were not a clarion call, the obesity epidemic certainly should be. The JELIS investigators should be commended, and their efforts should inspire additional clinical trials of the effects of fish oil and other dietary factors and habits on cardiovascular health."
The JELIS investigators recruited 18,645 patients from 1996 to 1999, with a total cholesterol of 6.5 mmol/L (253 mg/dL) or greater. The patients were randomly assigned to 1,800 mg of EPA daily with a statin (9,326 patients) or statin therapy alone (9,319).