{"id":17,"date":"2009-01-17T16:37:31","date_gmt":"2009-01-17T15:37:31","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=17"},"modified":"2015-11-12T13:19:03","modified_gmt":"2015-11-12T12:19:03","slug":"oout-of-hospital-arrest-location-is-everything","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/oout-of-hospital-arrest-location-is-everything\/","title":{"rendered":"Polyunsaturated fatty acids improve outcome in heart failure"},"content":{"rendered":"<p style=\"text-align: justify\">In the initial Gruppo Italiano per lo Studio della Sopravvivenza nell&#8217;infarto miocardico (GISSI) trial,\u00a0 patients taking n-3 polyunsaturated fatty acids (PUFA) after myocardial infarction had a lower mortality rate than those in the control group.\u00a0 The purpose of the GISSI-HF trial was to determine if PUFA could improve morbidity and mortality in patients with symptomatic heart failure of any cause.<!--more--><\/p>\n<p style=\"text-align: justify\">Patients with New York Heart Association heart failure class II-IV, irrespective of left ventricular ejection fraction, were randomly assigned to 1g PUFA (n=3494) or placebo (n=3481).\u00a0 Median follow up was 3.9 years; the primary endpoints were time to death, and time to death or admission to hospital for a cardiovascular cause.\u00a0 955 (27%) patients died from any cause in the n-3 PUFA group and 1014 (29%) in the placebo group (hazard ratio, 0.91; p=0.041).\u00a0 1981 (57%) patients in the PUFA group and 2053 (59%) in the placebo group died or were admitted to hospital for cardiovascular reasons (hazard ratio, 0.92; p=0.009).<\/p>\n<p style=\"text-align: justify\">In absolute terms the results suggest that 56 patients would need to be treated for a median of 3.9 years to avoid one death.\u00a0 Furthermore, PUFAs are cost-effective and have a low incidence of side-effects.\u00a0 Although two large-scale trials have now shown the clinical benefit of the drug, the exact mechanism of its action remains to be defined.\u00a0 Nonetheless, the results are encouraging given that a further paper from the GISSI-HF group, looking at the effect of rosuvastatin 10mg in heart failure, failed to show any benefit.<\/p>\n<ul>\n<li><strong>GISSI-HF investigators. Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomized, double-blind, placebo-controlled trial. Lancet 2008; DOI: 10.1016\/S0140-6736(08)61241-6.<\/strong><\/li>\n<li><strong>GISSI-HF investigators. Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomized, double-blind, placebo-controlled trial. Lancet 2008; DOI: 10.1016\/S0140-6736(08)61241-6.<\/strong><\/li>\n<li><strong>Fonarow GC. Statins and n-3 fatty acid supplementation in heart failure. Lancet 2008; DOI: 10.1016\/S0140-6736(08)61239-8.<\/strong><\/li>\n<\/ul>\n<p style=\"text-align: justify\">\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the initial Gruppo Italiano per lo Studio della Sopravvivenza nell&#8217;infarto miocardico (GISSI) trial,\u00a0 patients taking n-3 polyunsaturated fatty acids (PUFA) after myocardial infarction had a lower mortality rate than those in the control group.\u00a0 The purpose of the GISSI-HF trial was to determine if PUFA could improve morbidity and mortality in patients with symptomatic [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/heart\/2009\/01\/17\/oout-of-hospital-arrest-location-is-everything\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":47,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[279],"tags":[2955,497],"class_list":["post-17","post","type-post","status-publish","format-standard","hentry","category-general-cardiology","tag-heart-failure","tag-polyunsaturated-fatty-acids"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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