Cited by 1,311Fatty Acid Research and HealthAcute Myocardial Infarction ResearchCardiac Health and Mental Health

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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

Marchioli, Roberto, Barzi, Federica, Bomba, Elena, Chieffo, Carmine, Di Gregorio, Domenico, Di Mascio, Rocco, Franzosi, Maria Grazia, Geraci, Enrico, Levantesi, Giacomo, Maggioni, Aldo Pietro, Mantini, Loredana, Marfisi, Rosa Maria, Mastrogiuseppe, G., Mininni, Nicola, Nicolosi, Gian Luigi, Santini, Massimo, Schweiger, Carlo, Tavazzi, Luigi, Tognoni, Gianni, Tucci, Corrado, Valagussa, Franco·2002·Circulation

DOI 10.1161/01.cir.0000014682.14181.f2

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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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Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial
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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
ORCID: Barzi, Federica
Chieffo, Carmine
Maggioni, Aldo Pietro
Nicolosi, Gian Luigi
Tavazzi, Luigi
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2002-04-23
Volume: 105
Issue: 16
Pages: 1897-1903
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000014682.14181.f2
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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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

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