Eicosapentaenoic acid vs. docosahexaenoic acid for the prevention of cardiovascular disease.

IF 2.6 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI:10.1097/MED.0000000000000796

Ty E Sweeney, Sean P Gaine, Erin D Michos

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引用次数: 1

Abstract

Purpose of review: Populations with greater fatty fish intake have lower risk of coronary heart disease. However, trials testing omega-3 fatty acids (FA) on cardiovascular outcomes have yielded inconsistent results. In this review, we summarize the major cardiovascular trials examining omega-3 FA supplementation, and compare differences with eicosapentaenoic acid (EPA) alone vs. docosahexaenoic acid (DHA) combined with EPA.

Recent findings: The JELIS and REDUCE-IT trials both demonstrated significant reduction in cardiovascular events with high dose EPA in the form of icosapent ethyl (IPE), with a similar trend seen in the RESPECT-EPA trial. In contrast, the ASCEND, VITAL, STRENGTH, and OMEMI trials examining EPA+DPA combinations failed to demonstrate benefit. Beyond the difference in omega-3 FA formulations (IPE vs. omega-3 carboxylic acid), other differences between REDUCE-IT and STRENGTH include the achieved EPA levels, differing properties that EPA and DHA have on membrane stabilization, and the comparator oils tested in the trials.

Summary: The totality of evidence suggests EPA alone, administered in a highly-purified, high-dose form, improves cardiovascular outcomes among patients with elevated triglycerides at high cardiovascular risk, but EPA and DHA together does not. Current guidelines endorse the use of IPE in statin-treated patients at high cardiovascular risk who have triglycerides >135 mg/dl.

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二十碳五烯酸与二十二碳六烯酸预防心血管疾病。

综述的目的:摄入较多脂肪鱼类的人群患冠心病的风险较低。然而，测试omega-3脂肪酸(FA)对心血管疾病的影响的试验得出了不一致的结果。在这篇综述中，我们总结了研究omega-3 FA补充剂的主要心血管试验，并比较了单独使用二十碳五烯酸(EPA)与二十二碳六烯酸(DHA)联合EPA的差异。最近的研究发现:JELIS和REDUCE-IT试验均显示，使用高剂量的乙基二十碳二烯(IPE)形式的EPA可显著降低心血管事件，在RESPECT-EPA试验中也看到了类似的趋势。相比之下，检测EPA+DPA组合的ASCEND、VITAL、STRENGTH和OMEMI试验未能显示出益处。除了omega-3脂肪酸配方(IPE与omega-3羧酸)的差异之外，REDUCE-IT和STRENGTH之间的其他差异还包括达到的EPA水平，EPA和DHA在膜稳定方面的不同特性，以及试验中测试的比较油。总结:总的证据表明，EPA单独，以高纯化，高剂量形式给药，改善心血管高危患者甘油三酯升高的心血管结局，但EPA和DHA一起没有。目前的指南支持他汀类药物治疗的甘油三酯>135 mg/dl的心血管高危患者使用IPE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Endocrinology & Diabetes and Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.80

自引率

3.10%

发文量

128

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Endocrinology, Diabetes and Obesity delivers a broad-based perspective on the most recent and exciting developments in the field from across the world. Published bimonthly and featuring twelve key topics – including androgens, gastrointestinal hormones, diabetes and the endocrine pancreas, and neuroendocrinology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.