Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction: Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione
Abstract
Background — Our purpose was to assess the time course of the benefit of n-3 polyunsaturated fatty acids (PUFAs) on mortality documented by the GISSI-Prevenzione trial in patients surviving a recent (<3 months) myocardial infarction. Methods and Results — In this study, 11 323 patients were randomly assigned to supplements of n-3 PUFAs, vitamin E (300 mg/d), both, or no treatment (control) on top of optimal pharmacological treatment and lifestyle advice. Intention-to-treat analysis adjusted for interaction between treatments was carried out. Early efficacy of n-3 PUFA treatment for total, cardiovascular, cardiac, coronary, and sudden death; nonfatal myocardial infarction; total coronary heart disease; and cerebrovascular events was assessed by right-censoring follow-up data 12 times from the first month after randomization up to 12 months. Survival curves for n-3 PUFA treatment diverged early after randomization, and total mortality was significantly lowered after 3 months of treatment (relative risk [RR] 0.59; 95% CI 0.36 to 0.97; P =0.037). The reduction in risk of sudden death was specifically relevant and statistically significant already at 4 months (RR 0.47; 95% CI 0.219 to 0.995; P =0.048). A similarly significant, although delayed, pattern after 6 to 8 months of treatment was observed for cardiovascular, cardiac, and coronary deaths. Conclusions — The early effect of low-dose (1 g/d) n-3 PUFAs on total mortality and sudden death supports the hypothesis of an antiarrhythmic effect of this drug. Such a result is consistent with the wealth of evidence coming from laboratory experiments on isolated myocytes, animal models, and epidemiological and clinical studies.
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Contemporary high-intensity statin formulations achieve greater low-density lipoprotein-lowering effects and cardiovascular endpoint reduction than were used during the first mixed EPA/DHA trials, such as GISSI-P.
“contemporary high-intensity statin formulations achieve greater low-density lipoprotein–lowering effects and cardiovascular endpoint reduction than were used during the first mixed EPA/DHA trials, such as GISSI-P.17,27,44”
From Effects of Eicosapentaenoic Acid vs Eicosapentaenoic/Docosahexaenoic Acids on Cardiovascular Mortality (2025) · cites this paper as [44]
The Acknowledgements (page not available) identify GISSI-Prevenzione as a trial using mixed EPA/DHA capsules, and Table 1 (Statistical Methods; page not available) reports cholesterol-lowering drug use of 4.7% at baseline and 45.5% at 42 months. The paper does not compare those drugs with contemporary high-intensity statins or establish greater LDL lowering or cardiovascular endpoint reduction from such statins. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMeta-analyses suggest that a reduction in calculated glomerular filtration rate with fibrates does not reflect adverse effects on kidney function.
“Data from meta-analyses suggest that a reduction of calculated glomerular filtration rate (GFR) does not reflect any adverse effects on kidney function [315].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [315]
Other meta-analyses suggest reduced major cardiovascular events in patients with high triglycerides and low HDL cholesterol treated with fibrates, but no decrease in cardiovascular or total mortality.
“Results from other meta-analyses suggest reduced major CVD events in patients with high TGs and low HDL-C in fibrate-treated patients, but no decrease in CVD or total mortality [314-316].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [315]
In a post hoc subgroup analysis, the reduction in mortality and sudden cardiac death with n-3 PUFA was concentrated in patients with reduced left ventricular ejection fraction.
“A post hoc subgroup analysis revealed that this reduction in mortality and SCD was concentrated in the approximately 2000 patients with reduced left ventricular ejection fraction [67].”
From Update on Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Health (2022) · cites this paper as [67]
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Cites
de Lorgeril, M., Salen, P., Martin, J.-L., Monjaud, I., Delaye, J., & Mamelle, N. (1999) · Circulation · doi:10.1161/01.cir.99.6.779 · Cited by 2,910 · see citing works
Burr, M. L., Gilbert, J. F., Holliday, R. M., Elwood, P. C., Fehily, A. M., Rogers, S., Sweetnam, P. M., & Deadman, N. M. (1989) · The Lancet · doi:10.1016/s0140-6736(89)90828-3 · Cited by 2,610 · see citing works
The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart Disease
Kromhout, D., Bosschieter, E. B., & Coulander, C. D. L. (1985) · New England Journal of Medicine · doi:10.1056/nejm198505093121901 · Cited by 2,177 · see citing works
(1999) · PubMed · Cited by 2,062 · see citing works
Self-citationn-3 fatty acids and serum lipoproteins: human studies
Harris, W. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.5.1645s · Cited by 1,243 · see citing works
Fish Consumption and Risk of Sudden Cardiac Death
Albert, C. M. (1998) · JAMA · doi:10.1001/jama.279.1.23 · Cited by 990 · see citing works
The Composition of Food Consumed by Greenland Eskimos
Bang, H. O., Dyerberg, J., & Hjørne, N. (1976) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1976.tb08198.x · Cited by 950 · see citing works
Siscovick, D. S. (1995) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1995.03530170043030 · Cited by 920 · see citing works
Fish consumption and the 30-year risk of fatal myocardial infarction
Daviglus, M. L., Stamler, J., Orencia, A. J., Dyer, A. R., Liu, K., Greenland, P., Walsh, M. K., Morris, D., & Shekelle, R. B. (1997) · New England Journal of Medicine · doi:10.1056/nejm199704103361502 · Cited by 902 · see citing works
Kromann, N., & Green, A. (1980) · PubMed · Cited by 854 · see citing works
Kromann, N., & Green, A. (1980) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1980.tb01221.x · Cited by 713 · see citing works
Analysing Survival Data From Clinical Trials and Observational Studies
(1996) · Technometrics · doi:10.1080/00401706.1996.10484530 · Cited by 674 · see citing works
Pietinen, P., Ascherio, A., Korhonen, P. A., Hartman, A. M., Willett, W. C., Albanes, D., & Virtamo, J. R. K. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009047 · Cited by 557 · see citing works
Dietary Intake of Marine n-3 Fatty Acids, Fish Intake, and the Risk of Coronary Disease among Men
Ascherio, A., Rimm, E. B., Stampfer, M. J., Giovannucci, E. L., & Willett, W. C. (1995) · New England Journal of Medicine · doi:10.1056/nejm199504133321501 · Cited by 540 · see citing works
Singh, R. B., Niaz, M. A., Sharma, J. P., Kumar, R., Rastogi, V., & Moshiri, M. (1997) · Cardiovascular Drugs and Therapy · doi:10.1023/a:1007757724505 · Cited by 536 · see citing works
The Effect of Dietary ω-3 Fatty Acids on Coronary Atherosclerosis
von Schacky, C., Angerer, P., Kothny, W., Theisen, K., & Mudra, H. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-7-199904060-00003 · Cited by 487 · see citing works
Singh, R. B., Rastogi, S. S., Verma, R. K., Laxmi, B. V., Singh, R. B., Ghosh, S., & Niaz, M. A. (1992) · BMJ · doi:10.1136/bmj.304.6833.1015 · Cited by 457 · see citing works
Dolecek, T. A. (1992) · Experimental Biology and Medicine · doi:10.3181/00379727-200-43413 · Cited by 410 · see citing works
Prevention of Sudden Cardiac Death by Dietary Pure ω-3 Polyunsaturated Fatty Acids in Dogs
Billman, G. E., Kang, J. X., & Leaf, A. (1999) · Circulation · doi:10.1161/01.cir.99.18.2452 · Cited by 393 · see citing works
A clinical appraisal of left atrial function
Stefanadis, C. (2001) · European Heart Journal · doi:10.1053/euhj.1999.2581 · Cited by 282 · see citing works
Antiarrhythmic Effects of Polyunsaturated Fatty Acids
Kang, J. X., & Leaf, A. (1996) · Circulation · doi:10.1161/01.cir.94.7.1774 · Cited by 227 · see citing works
Christensen, J. H., Korup, E., Aarøe, J., Toft, E. S., Møller, J., Rasmussen, K., Dyerberg, J., & Schmidt, E. B. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00220-8 · Cited by 185 · see citing works
Dietary lipid modulation of ventricular fibrillation threshold in the marmoset monkey
McLennan, P. L., Bridle, T. M., Abeywardena, M. Y., & Charnock, J. S. (1992) · American Heart Journal · doi:10.1016/0002-8703(92)90809-a · Cited by 185 · see citing works
Fauchier, L., Babuty, D., Cosnay, P., & Fauchier, J. P. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00021-2 · Cited by 159 · see citing works
Rodríguez, B. L., Sharp, D. S., Abbott, R. D., Burchfiel, C. M., Masaki, K., Chyou, P., Huang, B., Yano, K., & Curb, J. D. (1996) · Circulation · doi:10.1161/01.cir.94.5.952 · Cited by 132 · see citing works
Marchioli, R. (2001) · European Heart Journal · doi:10.1053/euhj.2000.2544 · Cited by 130 · see citing works
Self-citationEffects of dietary fish oil on ventricular premature complexes
Sellmayer, A., Witzgall, H., Lorenz, R. L., & Weber, P. C. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80276-8 · Cited by 123 · see citing works
The 2 × 2 factorial design: Its application to a randomized trial of aspirin and U.S. physicians
Stampfer, M. J., Buring, J. E., Willett, W. C., ROSNER, B. A., Eberlein, K. A., & Hennekens, C. H. (1985) · Statistics in Medicine · doi:10.1002/sim.4780040202 · Cited by 120 · see citing works
n-3 fatty acids and serum lipoproteins: animal studies
Harris, W. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.5.1611s · Cited by 113 · see citing works
Omega-3 fatty acids in the prevention-management of cardiovascular disease.
Simopoulos, A. P. (1997) · PubMed · Cited by 109 · see citing works
Factorial designs for randomized clinical trials.
Byar, D. P., & Piantadosi, S. (1985) · PubMed · Cited by 85 · see citing works
n-3 fatty acids and ventricular extrasystoles in patients with ventricular tachyarrhythmias
Christensen, J. H., Gustenhoff, P., Ejlersen, E., Jessen, T. E., Korup, E., Rasmussen, K., Dyerberg, J., & Schmidt, E. B. (1995) · Nutrition Research · doi:10.1016/0271-5317(95)91647-u · Cited by 44 · see citing works
Marchioli, R. (2001) · European Heart Journal Supplements · doi:10.1016/s1520-765x(01)90126-9 · Cited by 28 · see citing works
Self-citationThe results of the GISSI-Prevenzione trial in the general framework of secondary prevention
Marchioli, R. (2000) · European Heart Journal · doi:10.1053/euhj.1999.1971 · Cited by 26 · see citing works
Self-citationBiochemistry and physiology of eicosanoid precursors in cell membranes
Lands, W. (2001) · European Heart Journal Supplements · doi:10.1016/s1520-765x(01)90114-2 · Cited by 8 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- Leaf A. The electrophysiologic basis for the antiarrhythmic actions of polyunsaturated fatty acids. Eur Heart J. 2001;22:D98 -D105.
- Billman GE, Kang JX, Leaf A. Prevention of ischemia-induced ventric- ular arrhythmias by dietary pure n-3 polyunsaturated fatty acids in dogs. Circulation. 1999;99:2452-2457.
- De Caterina R, Basta G. Biochemistry and physiology of eicosanoid precursors in cell membranes. Eur Heart J. 2001;22:D42-D49.
- Maggioni AP, Tavazzi L, Marchioli R, et al, on the behalf of the GISSI- group. Perspectives on n-3 PUFA: primary prevention, antiarrhythmic effects, congestive heart failure. Eur Heart J. 2001;22:D106 -D109.
Cited by
Sorted by citations
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854 · see citing works
Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease
Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002) · Circulation · doi:10.1161/01.cir.0000038493.65177.94 · Cited by 3,707 · see citing works
ESC/EAS Guidelines for the management of dyslipidaemias
Reiner, Ž., Catapano, A. L., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr158 · Cited by 3,549 · see citing works
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw272 · Cited by 3,162 · see citing works
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.12.012 · Cited by 2,862 · see citing works
Resolution of inflammation: the beginning programs the end
Serhan, C. N., & Savill, J. (2005) · Nature Immunology · doi:10.1038/ni1276 · Cited by 2,552 · see citing works
Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922 · see citing works
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Myerburg, R. J., Quiñones, M. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.010 · Cited by 1,962 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.054 · Cited by 1,883 · see citing works
Serhan, C. N., Hong, S., Gronert, K., Colgan, S. P., Devchand, P. R., Mirick, G., & Moussignac, R.-L. (2002) · The Journal of Experimental Medicine · doi:10.1084/jem.20020760 · Cited by 1,650 · see citing works
2016 ESC/EAS Guidelines for the Management of Dyslipidaemias
Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.08.018 · Cited by 1,582 · see citing works
Omega-3 fatty acids EPA and DHA: Health benefits throughout life
Swanson, D., Block, R., & Mousa, S. A. (2012) · Advances in Nutrition · doi:10.3945/an.111.000893 · Cited by 1,575 · see citing works
Optimal Diets for Prevention of Coronary Heart Disease
Hu, F. B. (2002) · JAMA · doi:10.1001/jama.288.20.2569 · Cited by 1,503 · see citing works
GISSI-HF investigators (2008) · The Lancet · doi:10.1016/s0140-6736(08)61239-8 · Cited by 1,350 · see citing works
Mozaffarian, D., Micha, R., & Wallace, S. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000252 · Cited by 1,215 · see citing works
Prepared, B. (2005) · Heart · doi:10.1136/hrt.2005.079988 · Cited by 1,217 · see citing works
Epidemiology of coronary heart disease and acute coronary syndrome
Sanchis-Gomar, F., Perez-Quilis, C., Leischik, R., & Lucia, A. (2016) · Annals of Translational Medicine · doi:10.21037/atm.2016.06.33 · Cited by 1,203 · see citing works
Functional Roles of Fatty Acids and Their Effects on Human Health
Calder, P. C. (2015) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607115595980 · Cited by 1,190 · see citing works
The Omega-3 Index: A new risk factor for death from coronary heart disease?
Harris, W. S., & von Schacky, C. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.02.030 · Cited by 1,111 · see citing works
Schizophrenia and increased risks of cardiovascular disease
Hennekens, C. H., Hennekens, A. R., Hollar, D., & Casey, D. E. (2005) · American Heart Journal · doi:10.1016/j.ahj.2005.02.007 · Cited by 1,070 · see citing works
Emulsion‐Based Delivery Systems for Lipophilic Bioactive Components
McClements, D. J., Decker, E. A., & Weiss, J. (2007) · Journal of Food Science · doi:10.1111/j.1750-3841.2007.00507.x · Cited by 1,025 · see citing works
Hong, S., Gronert, K., Devchand, P. R., Moussignac, R.-L., & Serhan, C. N. (2003) · Journal of Biological Chemistry · doi:10.1074/jbc.m300218200 · Cited by 1,000 · see citing works
Serhan, C. N. (2006) · Annual Review of Immunology · doi:10.1146/annurev.immunol.25.022106.141647 · Cited by 997 · see citing works
Wang, C., Harris, W. S., Chung, M., Lichtenstein, A. H., Balk, E. M., Kupelnick, B., Jordan, H. S., & Lau, J. (2006) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.1.5 · Cited by 980 · see citing works
Rizos, E. C., Ntzani, E. E., Bika, E., Kostapanos, M. S., & Elisaf, M. S. (2012) · JAMA · doi:10.1001/2012.jama.11374 · Cited by 960 · see citing works
McClements, D. J., Decker, E. A., Park, Y., & Weiß, J. (2009) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408390902841529 · Cited by 949 · see citing works
Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women
Mosca, L. J., Appel, L. J., Benjamin, E. J., Berra, K. A., Chandra‐Strobos, N., Fabunmi, R. P., Grady, D. G., Haan, C. K., Hayes, S. N., Judelson, D. R., et al. (2004) · Circulation · doi:10.1161/01.cir.0000114834.85476.81 · Cited by 917 · see citing works
Mechanisms of Action of (n-3) Fatty Acids,
Calder, P. C. (2012) · Journal of Nutrition · doi:10.3945/jn.111.155259 · Cited by 871 · see citing works
Russo, G. L. (2008) · Biochemical Pharmacology · doi:10.1016/j.bcp.2008.10.020 · Cited by 843 · see citing works
National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2
Jacobson, T. A., Maki, K. C., Orringer, C. E., Jones, P. H., Kris-Etherton, P., Sikand, G., La Forge, R., Daniels, S. R., Wilson, D. P., Morris, P. B., et al. (2015) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.09.002 · Cited by 784 · see citing works
Thies, F., Garry, J. M., Yaqoob, P., Rerkasem, K., Williams, J., Shearman, C. P., Gallagher, P. J., Calder, P. C., & Grimble, R. F. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12468-3 · Cited by 739 · see citing works
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Moss, A. J., Myerburg, R. J., et al. (2006) · EP Europace · doi:10.1093/europace/eul108 · Cited by 735 · see citing works
Chow, C. K., Jolly, S., Rao-Melacini, P., Fox, K. A. A., Anand, S. S., & Yusuf, S. (2010) · Circulation · doi:10.1161/circulationaha.109.891523 · Cited by 719 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000549 · Cited by 749 · see citing works
ESC/EAS Guidelines for the management of dyslipidaemias
Catapano, A. L., Reiner, Ž., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.06.028 · Cited by 706 · see citing works
Hooper, L., Thompson, R. L., Harrison, R. A., Summerbell, C. D., Ness, A. R., Moore, H. J., Worthington, H. V., Durrington, P. N., Higgins, J. P. T., Capps, N. E., et al. (2006) · BMJ · doi:10.1136/bmj.38755.366331.2f · Cited by 676 · see citing works
Fatty acid profiles of 80 vegetable oils with regard to their nutritional potential
Dubois, V., Breton, S., Linder, M., Fanni, J., & Parmentier, M. (2007) · European Journal of Lipid Science and Technology · doi:10.1002/ejlt.200700040 · Cited by 661 · see citing works
Omega-3 polyunsaturated fatty acids and cardiovascular diseases.
Lavie, C. J., Milani, R. V., Mehra, M. R., & Ventura, H. O. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.02.084 · Cited by 644 · see citing works
Al‐Khatib, S. M., Stevenson, W. G., Ackerman, M. J., Bryant, W. J., Callans, D. J., Curtis, A. B., Deal, B. J., Dickfeld, T. M., Field, M. E., Fonarow, G. C., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.036 · Cited by 639 · see citing works
Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease
Abdelhamid, A. S., Brown, T. J., Brainard, J. S., Biswas, P., Thorpe, G., Moore, H. J., Deane, K. H., AlAbdulghafoor, F. K., Summerbell, C. D., Worthington, H. V., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003177.pub3 · Cited by 631 · see citing works
Siscovick, D. S., Barringer, T. A., Fretts, A. M., Wu, J. H. Y., Lichtenstein, A. H., Costello, R. B., Kris-Etherton, P. M., Jacobson, T. A., Engler, M. B., Alger, H. M., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000482 · Cited by 629 · see citing works
Arachidonate 5-Lipoxygenase Promoter Genotype, Dietary Arachidonic Acid, and Atherosclerosis
Dwyer, J. H., Allayee, H., Dwyer, K. M., Fan, J., Wu, H., Mar, R., Lusis, A. J., & Mehrabian, M. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025079 · Cited by 614 · see citing works
Leaf, A., Kang, J. X., Xiao, Y.-F., & Billman, G. E. (2003) · Circulation · doi:10.1161/01.cir.0000069566.78305.33 · Cited by 605 · see citing works
Rauch, B., Schiele, R., Schneider, S., Diller, F., Victor, N., Gohlke, H., Gottwik, M., Steinbeck, G., Del Castillo, U., Sack, R., et al. (2010) · Circulation · doi:10.1161/circulationaha.110.948562 · Cited by 607 · see citing works
Inflammatory Disease Processes and Interactions with Nutrition
Calder, P. C., Albers, R., Antoine, J., Blum, S., Bourdet‐Sicard, R., Ferns, G. A., Folkerts, G., Friedmann, P. S., Frost, G. S., Guarner, F., et al. (2009) · British Journal Of Nutrition · doi:10.1017/s0007114509377867 · Cited by 570 · see citing works
n–3 Fatty Acids in Cardiovascular Disease
Caterina, R. D. (2011) · New England Journal of Medicine · doi:10.1056/nejmra1008153 · Cited by 568 · see citing works
n–3 Fatty acids and cardiovascular disease: evidence explained and mechanisms explored
Calder, P. C. (2004) · Clinical Science · doi:10.1042/cs20040119 · Cited by 561 · see citing works
Is atrial fibrillation an inflammatory disorder?
Boos, C. J., Anderson, R. A., & Lip, G. Y. H. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi645 · Cited by 549 · see citing works
n–3 Fatty Acids in Patients with Multiple Cardiovascular Risk Factors
The Risk and Prevention Study Collaborative Group (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1205409 · Cited by 510 · see citing works
Cardiovascular effects of marine omega-3 fatty acids
Saravanan, P., Davidson, N. C., Schmidt, E. B., & Calder, P. C. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60445-x · Cited by 510 · see citing works
Anti-Inflammatory and Proresolving Lipid Mediators
Serhan, C. N., Yacoubian, S., & Yang, R. (2008) · Annual Review of Pathology Mechanisms of Disease · doi:10.1146/annurev.pathmechdis.3.121806.151409 · Cited by 511 · see citing works
N-3 Fatty Acids for the Prevention of Atrial Fibrillation After Coronary Artery Bypass Surgery
Calò, L., Bianconi, L., Colivicchi, F., Lamberti, F., Loricchio, M. L., Ruvo, E. D., Meo, A., Pandozi, C., Staibano, M., & Santini, M. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.02.079 · Cited by 507 · see citing works
Self-citationFish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease
Kris‐Etherton, P. M., Harris, W. S., & Appel, L. J. (2003) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000038493.65177.94 · Cited by 501 · see citing works
Serhan, C. N., Dalli, J., Colas, R. A., Winkler, J. W., & Chiang, N. (2015) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2014.08.006 · Cited by 492 · see citing works
The mechanisms of air pollution and particulate matter in cardiovascular diseases
Fiordelisi, A., Piscitelli, P., Trimarco, B., Coscioni, E., Iaccarino, G., & Sorriento, D. (2017) · Heart Failure Reviews · doi:10.1007/s10741-017-9606-7 · Cited by 485 · see citing works
Fruchart, J.-C., Sacks, F., Hermans, M. P., Assmann, G., Brown, W. V., Ceska, R., Chapman, M. J., Dodson, P. M., Fioretto, P., Ginsberg, H. N., et al. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.10.002 · Cited by 463 · see citing works
Galan, P., Kesse-Guyot, E., Czernichow, S., Briancon, S., Blacher, J., Hercberg, S., & for the SU.FOL.OM3 Collaborative Group (2010) · BMJ · doi:10.1136/bmj.c6273 · Cited by 457 · see citing works
Serhan, C. N., Gotlinger, K. H., Hong, S., Lu, Y., Siegelman, J. N., Baer, T. E., Yang, R., Colgan, S. P., & Petasis, N. A. (2006) · The Journal of Immunology · doi:10.4049/jimmunol.176.3.1848 · Cited by 457 · see citing works
Endogenous pro‐resolving and anti‐inflammatory lipid mediators: a new pharmacologic genus
Serhan, C. N., & Chiang, N. (2007) · British Journal of Pharmacology · doi:10.1038/sj.bjp.0707489 · Cited by 428 · see citing works
Schofield, J. D., Liu, Y., Rao‐Balakrishna, P., Malik, R. A., & Soran, H. (2016) · Diabetes Therapy · doi:10.1007/s13300-016-0167-x · Cited by 423 · see citing works
Zivkovic, A. M., German, J. B., & Sanyal, A. J. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.2.285 · Cited by 418 · see citing works
Very long-chain <i>n</i> -3 fatty acids and human health: fact, fiction and the future
Calder, P. C. (2018) · Proceedings of the Nutrition Society · doi:10.1017/s0029665117003950 · Cited by 419 · see citing works
Dietary reference intakes for DHA and EPA
Kris‐Etherton, P. M., Grieger, J. A., & Etherton, T. D. (2009) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2009.05.011 · Cited by 405 · see citing works
Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease
Abdelhamid, A. S., Brown, T. J., Brainard, J. S., Biswas, P., Thorpe, G., Moore, H. J., Deane, K. H., AlAbdulghafoor, F. K., Summerbell, C. D., Worthington, H. V., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003177.pub4 · Cited by 409 · see citing works
n−3 Fatty acids and cardiovascular disease
Breslow, J. L. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/83.6.1477s · Cited by 404 · see citing works
Bergé, J. P., & Barnathan, G. (2005) · Advances in biochemical engineering, biotechnology · doi:10.1007/b135782 · Cited by 399 · see citing works
The Role of the Autonomic Nervous System in Sudden Cardiac Death
Vaseghi, M., & Shivkumar, K. (2008) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2008.01.003 · Cited by 397 · see citing works
Lemaître, R. N., King, I. B., Mozaffarian, D., Kuller, L. H., Tracy, R. P., & Siscovick, D. S. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.2.319 · Cited by 393 · see citing works
Resolvins and protectins in the termination program of acute inflammation
Ariel, A., & Serhan, C. N. (2007) · Trends in Immunology · doi:10.1016/j.it.2007.02.007 · Cited by 379 · see citing works
Raitt, M. H., Connor, W. E., Morris, C., Kron, J., Halperin, B., Chugh, S. S., McClelland, J., Cook, J., MacMurdy, K., Swenson, R., et al. (2005) · JAMA · doi:10.1001/jama.293.23.2884 · Cited by 371 · see citing works
Health Benefits of n-3 Polyunsaturated Fatty Acids
Siriwardhana, N., Kalupahana, N. S., & Moustaïd‐Moussa, N. (2012) · Advances in food and nutrition research · doi:10.1016/b978-0-12-416003-3.00013-5 · Cited by 368 · see citing works
Marine Omega-3 (N-3) Fatty Acids for Cardiovascular Health: An Update for 2020
Innes, J. K., & Calder, P. C. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21041362 · Cited by 382 · see citing works
Sokoła-Wysoczańska, E., Wysoczański, T., Wagner, J., Czyż, K., Bodkowski, R., Lochyński, S., & Patkowska-Sokoła, B. (2018) · Nutrients · doi:10.3390/nu10101561 · Cited by 363 · see citing works
Towards establishing dietary reference intakes for eicosapentaenoic and docosahexaenoic acids
Harris, W. S., Mozaffarian, D., Lefevre, M., Toner, C. D., Colombo, J., Cunnane, S. C., Holden, J. M., Klurfeld, D. M., Morris, M. C., & Whelan, J. (2009) · The Journal of Nutrition · doi:10.3945/jn.108.101329 · Cited by 356 · see citing works
Farzaneh‐Far, R. (2010) · JAMA · doi:10.1001/jama.2009.2008 · Cited by 354 · see citing works
Arachidonic Acid-metabolizing Cytochrome P450 Enzymes Are Targets of ω-3 Fatty Acids*
Arnold, C., Markovic, M., Blossey, K., Wallukat, G., Fischer, R., Dechend, R., Konkel, A., von Schacky, C., Luft, F. C., Müller, D. N., et al. (2010) · Journal of Biological Chemistry · doi:10.1074/jbc.m110.118406 · Cited by 353 · see citing works
Serhan, C. N., Arita, M., Hong, S., & Gotlinger, K. H. (2004) · Lipids · doi:10.1007/s11745-004-1339-7 · Cited by 349 · see citing works
Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women
Mosca, L., Appel, L., Benjamin, E., Berra, K., Chandra‐Strobos, N., Fabunmi, R., Grady, D., Haan, C., Hayes, S., Judelson, D., et al. (2004) · Circulation · doi:10.1161/01.atv.0000114834.85476.81 · Cited by 783 · see citing works
Cardiovascular benefits of omega-3 fatty acids
Vonschacky, C., & Harris, W. S. (2006) · Cardiovascular Research · doi:10.1016/j.cardiores.2006.08.019 · Cited by 335 · see citing works
Understanding the Divergent Data on Postmenopausal Hormone Therapy
Grodstein, F., Clarkson, T. B., & Manson, J. E. (2003) · New England Journal of Medicine · doi:10.1056/nejmsb022365 · Cited by 328 · see citing works
Omega-3 Fatty Acids in Cardiac Biopsies From Heart Transplantation Patients
Harris, W. S., Sands, S. A., Windsor, S. L., Ali, H. A., Stevens, T. L., Magalski, A., Porter, C., & Borkon, A. M. (2004) · Circulation · doi:10.1161/01.cir.0000142292.10048.b2 · Cited by 325 · see citing works
Oppedisano, F., Macrì, R., Gliozzi, M., Musolino, V., Carresi, C., Maiuolo, J., Bosco, F., Nucera, S., Zito, M. C., Guarnieri, L., et al. (2020) · Biomedicines · doi:10.3390/biomedicines8090306 · Cited by 326 · see citing works
Antidepressant-Induced Sexual Dysfunction
Gregorian, R. S., Golden, K. A., Bahce, A., Goodman, C., Kwong, W. J., & Khan, Z. M. (2002) · Annals of Pharmacotherapy · doi:10.1345/aph.1a195 · Cited by 320 · see citing works
Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction
Kalstad, A. A., Myhre, P. L., Laake, K., Tveit, S. H., Schmidt, E. B., Smith, P., Nilsen, D. W. T., Tveit, A., Fagerland, M. W., Solheim, S., et al. (2021) · Circulation · doi:10.1161/circulationaha.120.052209 · Cited by 311 · see citing works
Serhan, C. N., Gotlinger, K. H., Hong, S., & Arita, M. (2004) · Prostaglandins & Other Lipid Mediators · doi:10.1016/j.prostaglandins.2004.03.005 · Cited by 311 · see citing works
Durrington, P. N. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14234-1 · Cited by 311 · see citing works
Hu, F. B., Cho, E., Rexrode, K. M., Albert, C. M., & Manson, J. E. (2003) · Circulation · doi:10.1161/01.cir.0000062644.42133.5f · Cited by 302 · see citing works
The omega-3 index as a risk factor for coronary heart disease
Harris, W. S. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.6.1997s · Cited by 298 · see citing works
Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease
Abdelhamid, A. S., Brown, T. J., Brainard, J. S., Biswas, P., Thorpe, G. C., Moore, H. J., Deane, K. H., Summerbell, C. D., Worthington, H. V., Song, F., et al. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003177.pub5 · Cited by 295 · see citing works
Omega-3 fatty acids improve the diagnosis-related clinical outcome*
Heller, A. R., Rößler, S., Litz, R. J., Stehr, S. N., Heller, S. C., Koch, R., & Koch, T. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000206309.83570.45 · Cited by 297 · see citing works
Resolvins and protectins: mediating solutions to inflammation
Kohli, P., & Levy, B. D. (2009) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2009.00290.x · Cited by 293 · see citing works
Health benefits of marine foods and ingredients
Larsen, R., Eilertsen, K., & Elvevoll, E. O. (2011) · Biotechnology Advances · doi:10.1016/j.biotechadv.2011.05.017 · Cited by 294 · see citing works
O'Keefe, J. H., & Cordain, L. (2004) · Mayo Clinic Proceedings · doi:10.4065/79.1.101 · Cited by 289 · see citing works
Air pollution, oxidative stress and dietary supplementation: a review
Romieu, I., Castro-Giner, F., Künzli, N., & Sunyer, J. (2007) · European Respiratory Journal · doi:10.1183/09031936.00128106 · Cited by 289 · see citing works
Omega-3 fatty acids and cardiovascular disease: A case for omega-3 index as a new risk factor
Harris, W. S. (2007) · Pharmacological Research · doi:10.1016/j.phrs.2007.01.013 · Cited by 278 · see citing works
Omega-3 Free Fatty Acids for the Maintenance of Remission in Crohn Disease
Feagan, B. G., Sandborn, W. J., Mittmann, U., Bar–Meir, S., D’Haens, G., Bradette, M., Cohen, A., Dallaire, C., Ponich, T. P., McDonald, J. W., et al. (2008) · JAMA · doi:10.1001/jama.299.14.1690 · Cited by 275 · see citing works
Backer, G. D., Ambrosioni, E., Broch-Johnsen, K., Brotons, C., Cífková, R., Dallongeville, J., Ebrahim, S. B. J., Færgeman, O., Graham, I. D., Mancia, G., et al. (2003) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/00149831-200312001-00001 · Cited by 273 · see citing works
Tissue n−3 and n−6 fatty acids and risk for coronary heart disease events
Harris, W. S., Poston, W. C., & Haddock, C. K. (2007) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2007.03.018 · Cited by 271 · see citing works
Iestra, J. A., Kromhout, D., van der Schouw, Y. T., Grobbee, D. E., Boshuizen, H. C., & van Staveren, W. A. (2005) · Circulation · doi:10.1161/circulationaha.104.503995 · Cited by 262 · see citing works
Very long chain omega‐3 (n‐3) fatty acids and human health
Calder, P. C. (2014) · European Journal of Lipid Science and Technology · doi:10.1002/ejlt.201400025 · Cited by 265 · see citing works
- Authors
- Marchioli, R., Barzi, F., Bomba, E., Chieffo, C., Di Gregorio, D., Di Mascio, R., Franzosi, M. G., Geraci, E., Levantesi, G., Maggioni, A. P., Mantini, L., Marfisi, R. M., Mastrogiuseppe, G., Mininni, N., Nicolosi, G. L., Santini, M., Schweiger, C., Tavazzi, L., Tognoni, G., Tucci, C., & Valagussa, F.
- Affiliations
- Mario Negri Institute for Pharmacological Research (IT)
- From the Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti (R.M., F.B., E.B., R.D.M., R.M.M., G.T.); Ospedale Civile, Caserta (C.C.); Ospedale Civile, Lanciano (D.D.G., L.M., G.M., C.T.); Department of Cardiovascular Research, Istituto Mario Negri, Milano (M.G.F.); Ospedale Cervello, Palermo (E.G.); Ospedale Civile, Vasto (G.L.); Centro Studi ANMCO, Firenze (A.P.M.); Ospedale Civile, Napoli (N.M.); Ospedale S. Maria degli Angeli, Pordenone (G...
- Corresponding author
- Marchioli, Roberto
- Venue
- Circulation
- Published
- 2002-04-23
- Volume
- 105
- Issue
- 16
- Pages
- 1897-1903
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2128788220
- Cited by
- 1,311
- References
- 36
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 27 · 2023: 18 · 2022: 21 · 2021: 17 · 2020: 30 · 2019: 20 · 2018: 33 · 2017: 42 · 2016: 42 · 2015: 49 · 2014: 64 · 2013: 87 · 2012: 84
- FWCI
- 60.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Istituto di Ricerche Farmacologiche Mario Negri - IRCCS
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- omega-3 fatty acids, myocardial infarction, sudden death, mortality, vitamin E, antiarrhythmic effect, time course of treatment effects, cardiovascular mortality, coronary artery disease, cerebrovascular events
- MeSH terms
- Anti-Arrhythmia Agents, Female, Follow-Up Studies, Humans, Italy, Kinetics, Lipids, Male, Middle Aged, Myocardial Infarction, Fatty Acids, Omega-3, Death, Sudden, Cardiac, Dietary Supplements
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