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ACC大咖谈丨Omega-3脂肪酸心血管获益仍存争议,服用需谨慎!
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 标签:  关键字:Omega-3脂肪酸! 

     编者按:近年来,有研究表明Omega-3脂肪酸有益健康,因此,它一度在世界范围内得到广泛青睐。但也有研究发现,Omega-3脂肪酸对心血管健康并无益处。因此,omega-3脂肪酸能否带来健康获益仍存争议,本刊特邀美国克利夫兰诊所Steven E. Nissen教授谈谈他对Omega-3脂肪酸的认识。


    《国际循环》:有研究表明,Omega-3脂肪酸具有改善心血管疾病的作用,您怎么看?

    Steven E. Nissen教授:大多数研究并未显示出omega-3对心血管的获益,实际上,只有一两项研究表明有获益。此外,几项大型试验,例如ASCEND,ORIGIN和VITAL也未显示omega-3有获益。我们的研究STRENGTH试验纳入13 078例患者,但结果并未显示出omega-3有任何获益。因此,我认为omega-3脂肪酸是否对心血管结局具有获益尚不确定。
 
 
    《国际循环》:对心血管风险高的患者,Omega-3脂肪酸水平与主要不良心血管事件有哪些关系?

    Steven E. Nissen教授:我们在STRENGTH试验中进行了辅助分析,并对此进行了研究,该分析已发布,在这次ACC 2021大会上公布。我们在13 078例患者中进行试验,其中一半接受玉米油安慰剂,另一半接受omega-3脂肪酸,发现二十碳五烯酸(EPA)或二十二碳六烯酸(DHA)的水平与心血管疾病的结果之间没有任何关系。因此,我们认为这倾向于支持以下假设:Omega-3脂肪酸没有益处,因为该水平与心血管疾病的预后无关。
 
 
 
    《国际循环》:通过膳食或补充摄入Omega-3脂肪酸能否预防房颤?请谈谈您的观点

    Steven E. Nissen教授:最近有三项研究使用了相对较高剂量的omega-3脂肪酸REDUCE-IT,STRENGTH和OMEMI研究,结果三项均显示房颤风险增加>50%。在我们的研究中,STRENGTH增长69%,在REDUCE-IT中,增加了50%,而在OMEMI中,这一数字增长了89%。
 
 
    专访原文

    《International Circulation》:Some studies have shown that Omega-3 fatty acids can improve cardiovascular disease. What is your opinion?

    Professor Steven E. Nissen: Most studies have NOT shown benefit from omega-3. There are really only one or two studies that have suggested a benefit. The very large trials, such as ASCEND, ORIGIN and VITAL, showed no benefit. Our study, STRENGTH, which was 13000 patients, showed no benefit. So I think it is quite uncertain whether omega-3 fatty acids provide any benefit to cardiovascular outcomes.
 
    《International Circulation》:For patients with high cardiovascular risk, what is the relationship between Omega-3 fatty acid levels and major adverse cardiovascular events?

    Professor Steven E. Nissen:We studied this in a secondary analysis in STRENGTH, which is being published at this ACC 2021 conference.What we found in more than 10000 patients, half of whom received corn oil placebo and half of whom received omega-3 fatty acids, was that there was no relationship between the levels achieved of EPA or DHA and cardiovascular outcomes. We think this tends to support the hypothesis that there is no benefit of omega-3 fatty acids, since the levels had no relationship to cardiovascular outcomes.
 
    《International Circulation》:Can dietary or supplemental intake of Omega-3 fatty acids prevent atrial fibrillation? Would you please share us your opinion?

    Professor Steven E. Nissen:There are now three studies recently using relatively high doses of omega-3 fatty acids – REDUCE-IT, STRENGTH and the OMEMI study. All three of them showed >50% increase in the risk of atrial fibrillation. In our study, STRENGTH, it was a 69% increase. In REDUCE-IT, it was a 50% increase. And in OMEMI, it was an 89% increase.
 
 
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