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(Circulation. 2002;105:e9098.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

Reanalysis of Gissi-Prevenzione Demonstrates Antiarrhythmic Effect

When the Grupo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico prevensione (GISSI-Prevensione) trial was first analyzed, it appeared evident that increased intake (1 gram per day) of n-3 polyunsaturated fatty acids (PUFA) reduced overall and cardiovascular mortality without affecting the risk of nonfatal coronary events. In this week’s issue of Circulation (Circulation. 2002;105:1897–1903), researchers involved in the study, led by Roberto Marchioli, MD, reanalyzed the data based on the time-course of the effects of the n-3 PUFA in the large study.

In the study, 11 232 patients were assigned to receive supplements of either n-3 PUFA, vitamin E (300 mg daily), both, or no treatment, in addition to optimal drug treatment and lifestyle advice. The efficacy of the 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.

Marchioli et al found that the survival curves for the n-3 PUFA treatment diverged early after the patients were randomized, and that total mortality was significantly lower after 3 months of treatment. At 4 months, the reduction in the risk of sudden death was specifically relevant and statistically significant. A similar pattern was seen for cardiovascular, cardiac, and coronary deaths.

From this, the researchers surmised that the early effect of the n-3 PUFA treatment on both total mortality and sudden cardiac death meant that the treatment had an antiarrhythmic effect, a . . . [Full Text of this Article]