N-3 polyunsaturated fatty acids in patients with chronic heart failure – the GISSI-HF trial Review article
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Abstract
The favourable effect of n-3 polyunsaturated fatty acids on atherothrombotic cardiovascular diseases, including arrhythmias has been investigated in epidemiological and experimental trials. In GISSI-HF the authors evaluated the influence of n-3 PUFA on patients with chronic heart failure. It was a randomised, double – blind, placebo – controlled trial among 6975 patients from 357 italian medical centres. People with NYHA II–IV heart failure (no matter of the aetiology or left ventricle eject fraction) were divided into groups receiving 1 g PUFA (n=3494) or placebo (n=3481). The follow – up lasted about 4 years. Primary end points were time to death, and time to death or admission to hospital of cardiovascular reasons. In patients treated with PUFA 955 (27%) people died from any cause and 1981 (57%) people died or were hospitalized for cardiovascular causes; in placebo group respectively 1014 (29%) (HR=0,91, 95,5% CI: 0,833–0,998, p=0,041) and 2053 (59%) (HR=0,92, 99% CI: 0,849–0,999, p=0,009). In general, 56 patients needed to be treated for a median duration of 4 years to avoid one death or 44 to avoid one cardiovascular event (death or hospitalization). The adverse reaction (96 [3%] in PUFA and 92 [3%] in placebo group) were caused by the gastrointestinal disorders. The GISSI-HF trial proved that simple and safe treatment with n-3 PUFA in patients with chronic heart failure has a beneficial effect on the therapy, reduces mortality and the number of hospitalizations.
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