The DOI matches its Crossref record, with a small difference in title or year; 36 of the 36 references it cites were found in a registry or an index.
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.17,27,44”
From Effects of Eicosapentaenoic Acid vs Eicosapentaenoic/Docosahexaenoic Acids on Cardiovascular Mortality (2025) · cites this paper as [44]
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“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]
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“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]
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“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
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The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart Disease
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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
Fish Consumption and Risk of Sudden Cardiac Death
Albert, C. M. (1998) · JAMA · doi:10.1001/jama.279.1.23 · Cited by 990
The Composition of Food Consumed by Greenland Eskimos
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Siscovick, D. S. (1995) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1995.03530170043030 · Cited by 920
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
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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
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
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
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
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
Metadata
- 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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