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  • 1
    Language: English
    In: The American heart journal, 2007, Vol.153 (6), p.1037-1047
    Description: Background Various innovative pharmacologic strategies for the treatment of patients with pulmonary hypertension have been tested in recent years. Neither their comparative efficacy on surrogate end points nor the overall impact on mortality have been formally reviewed. Methods We did a systematic overview of all randomized trials on the therapeutic yield of prostacyclin and analogues, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors in patients with pulmonary hypertension searched in EMBASE, MEDLINE, and CINAHL databases from January 1985 to December 2005. Results Sixteen trials involving 1962 patients met the inclusion criteria. Up to 80% of the patients were in functional class III/IV with a median walking distance of 330 m at baseline. Overall, experimental treatments were associated with (1) a nonsignificant reduction in all-cause mortality (relative risk 0.70, 95% CI 0.41-1.22), (2) a minor but statistically significant improvement in exercise capacity of 42.8 m (95% CI 27.8-57.8), and (3) an improved dyspnea status by at least one functional class (relative risk 1.83, 95% CI 1.26-2.66). Changes in exercise capacity were not found to be predictive of a survival benefit. Conclusions Although confirming the limited benefits in clinical end points documented by each trial, the overview fails to support a significant survival advantage and does not support the predictive power of surrogate end points.
    Subject(s): Cardiovascular ; Cardiology. Vascular system ; Biological and medical sciences ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Medical sciences ; Pneumology ; Severity of Illness Index ; Hypertension, Pulmonary - mortality ; Phosphodiesterase Inhibitors - therapeutic use ; Predictive Value of Tests ; Hypertension, Pulmonary - classification ; Humans ; Survival Rate ; Treatment Outcome ; Epoprostenol - therapeutic use ; Epoprostenol - analogs & derivatives ; Exercise ; Exercise Tolerance ; Hypertension, Pulmonary - drug therapy ; Endothelin Receptor Antagonists ; Hypertension ; Drug therapy ; Methods ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-8703
    E-ISSN: 1097-6744
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  • 2
    Language: English
    In: The Lancet (British edition), 2010, Vol.375 (9716), p.735-742
    Description: Summary Background Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes. Methods We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I2 statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis. Findings We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1·09; 95% CI 1·02–1·17), with little heterogeneity ( I2 =11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150–852) patients with statins for 4 years resulted in one extra case of diabetes. Interpretation Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change. Funding None.
    Subject(s): Internal Medicine ; General aspects ; Diabetes. Impaired glucose tolerance ; Biological and medical sciences ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Medical sciences ; Endocrine pancreas. Apud cells (diseases) ; Age Distribution ; Age Factors ; Cardiovascular Diseases - drug therapy ; Humans ; Middle Aged ; Risk Factors ; Male ; Treatment Outcome ; Anticholesteremic Agents - adverse effects ; Diabetes Mellitus, Type 2 - epidemiology ; Randomized Controlled Trials as Topic ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Female ; Aged ; Diabetes Mellitus, Type 2 - chemically induced ; Complications and side effects ; Dosage and administration ; Diabetes ; Research ; Risk factors ; Statins ; Index Medicus ; Abridged Index Medicus
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 3
    Language: English
    In: The American heart journal, 2010, Vol.159 (2), p.245-257
    Description: Background In a previous metaanalysis on the approved treatments for pulmonary hypertension, we reported that all therapies caused small changes in 6-minute walk distance over a short period, with minimal effects on hemodynamics and no effect on survival. Since that last review, 10 new clinical trials with about 1,500 patients have been published, which has increased the statistical power of our observations. Methods A systematic review of all clinical trials in pulmonary arterial hypertension was done. Results The pooled effect of all treatments strategies (relative risk [95% CI], P ) now shows a significant reduction of 39% (2%-62%, P = .041) in all-cause mortality. The benefits were confined only to patients with advanced disease for 16 weeks, regardless of which class of drug is used. When considering the effects within each drug family, no class of drug produced a statistically significant reduction in all-cause mortality. The improved survival bore no relationship with the change in 6-minute walk, the primary end point in most of the trials. Conclusions The impact of vasodilators on long-term survival in pulmonary arterial hypertension remains uncertain. Future trials need to ( a ) adopt new trial designs that can better address clinical benefits, ( b ) use new end points that incorporate our best understanding of the disease rather than the ones that are easy to administer, and ( c ) include longer durations of study and other strategies to clarify if survival is affected.
    Subject(s): Cardiovascular ; Cardiology. Vascular system ; Biological and medical sciences ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Medical sciences ; Pneumology ; Randomized Controlled Trials as Topic - statistics & numerical data ; Hypertension, Pulmonary - drug therapy ; Vasodilator Agents - therapeutic use ; Humans ; Hypertension ; Blood vessels ; Clinical trials ; Respiratory agents ; Dilatation ; Vasodilators ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-8703
    E-ISSN: 1097-6744
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  • 4
    Language: English
    In: Journal of clinical oncology, 2005-04-01, Vol.23 (10), p.2224-2232
    Description: The clinical course of polycythemia vera is often complicated by thrombosis as well as by the possible transition to myeloid metaplasia with myelofibrosis or acute myeloid leukemia. The aim of this study was to assess the rate of these complications in subjects receiving currently recommended treatments. Overall, 1,638 patients from 12 countries were enrolled onto a large, prospective multicenter project aimed at describing the clinical history of polycythemia vera for the following outcomes: survival, the cumulative rate of cardiovascular death and thrombosis, the cumulative rate of leukemia, myelodysplasia, and myelofibrosis. The mean duration of the disease at entry and the duration of the follow-up were 4.9 and 2.7 years, respectively. The overall mortality rate of 3.7 deaths per 100 persons per year resulted from a moderate risk of cardiovascular death and a high risk of death from noncardiovascular causes (mainly hematologic transformations). Age older than 65 years and a positive history of thrombosis were the most important predictors of cardiovascular events. Antiplatelet therapy, but not cytoreductive treatment, was significantly associated with a lower risk of cardiovascular events. We found a consistent association between age and risk of leukemia, and between duration of the disease with risk of myelofibrosis. The European Collaboration on Low-Dose Aspirin in Polycythemia Vera study documents that large international collaborative studies are feasible in this field, in which few epidemiologic data are available. The persistently high mortality rate from hematologic malignancies characterizes the unmet therapeutic need of polycythemic patients and suggests a priority for future studies in this disease.
    Subject(s): Cardiovascular Diseases - etiology ; Prospective Studies ; Humans ; Middle Aged ; Risk Factors ; Male ; Polycythemia Vera - therapy ; Polycythemia Vera - complications ; Leukemia - etiology ; Time Factors ; Thrombosis - etiology ; Survival Analysis ; Cardiovascular Diseases - mortality ; Female ; Aged ; Thrombosis - mortality ; Cohort Studies ; Leukemia - mortality ; Index Medicus
    ISSN: 0732-183X
    E-ISSN: 1527-7755
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 5
    Language: English
    In: The American heart journal, 2013, Vol.165 (2), p.208-215.e4
    Description: Background Treatment with long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) can improve clinical outcomes in patients with heart failure (HF). Circulating levels of n-3 PUFA, an objective estimation of exposure, have never been measured in a large cohort of patients with HF. Methods We measured n-3 PUFA in plasma phospholipids at baseline and after 3 months in 1,203 patients with chronic HF enrolled in the GISSI-Heart Failure trial and randomized to n-3 PUFA 1 g/daily or placebo. N-3 PUFA levels were related to clinical characteristics, pharmacologic treatments, dietary habits, circulating biomarkers, and mortality. Results Baseline n-3 PUFA (5.1 ± 1.8 mol%) was associated with dietary fish intake, with an average difference of 43% between patients with the lowest and highest consumptions ( P 〈 .0001). Baseline eicosapentaenoic acid (EPA) but not docosahexaenoic acid (DHA) was inversely related to C-reactive protein, pentraxin-3, adiponectin, natriuretic peptide, and troponin levels. Three-month treatment with n-3 PUFA raised their levels by 43%, independently of dietary fish consumption; increases in EPA levels were associated with decreased pentraxin-3. Low baseline levels of EPA but not DHA were no longer related to higher mortality after the addition of circulating biomarkers to multivariable models. Conclusion Before supplementation, circulating n-3 PUFA levels in patients with chronic HF mainly depend on dietary fish consumption and are inversely related to inflammatory markers and disease severity. Three-month treatment with n-3 PUFA markedly enriched circulating EPA and DHA, independently of fish intake, and lowered pentraxin-3. Low EPA levels are inversely related to total mortality in patients with chronic HF.
    Subject(s): Cardiovascular ; Prospective Studies ; Survival Rate - trends ; Double-Blind Method ; Follow-Up Studies ; Humans ; Male ; Biomarkers - blood ; Heart Failure - blood ; Fatty Acids, Omega-3 - pharmacokinetics ; Fatty Acids, Omega-3 - blood ; Female ; Fish Oils - administration & dosage ; Italy - epidemiology ; Aged ; Heart Failure - diet therapy ; Dietary Supplements ; Fatty Acids, Omega-3 - administration & dosage ; Heart Failure - mortality ; Heart failure ; Unsaturated fatty acids ; Health aspects ; Cardiac patients ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-8703
    E-ISSN: 1097-6744
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  • 6
    Language: English
    In: Haematologica (Roma), 2011-02-01, Vol.96 (2), p.315-318
    Description: We tested the hypothesis that levels of pentraxin high sensitivity C-reactive protein and pentraxin 3 might be correlated with cardiovascular complications in patients with essential thrombocythemia and polycythemia vera. High sensitivity C-reactive protein and pentraxin 3 were measured in 244 consecutive essential thrombocythemia and polycythemia vera patients in whom, after a median follow up of 5.3 years (range 0-24), 68 cardiovascular events were diagnosed. The highest C-reactive protein tertile was compared with the lowest (〉3 vs. 〈1 mg/L) and correlated with age (P=0.001), phenotype (polycythemia vera vs. essential thrombocythemia, P=0.006), cardiovascular risk factors (P=0.012) and JAK2V617F allele burden greater than 50% (P=0.003). Major thrombosis rate was higher in the highest C-reactive protein tertile (P=0.01) and lower at the highest pentraxin 3 levels (P=0.045). These associations remained significant in multivariate analyses and indicate that blood levels of high sensitivity C-reactive protein and petraxin 3 independently and in opposite ways modulate the intrinsic risk of cardiovascular events in patients with myeloproliferative disorders.
    Subject(s): Hematologic and hematopoietic diseases ; Polycythemias ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Medical sciences ; Diseases of red blood cells ; Prognosis ; Follow-Up Studies ; Humans ; Middle Aged ; Polycythemia Vera - blood ; Male ; Young Adult ; Polycythemia Vera - complications ; Inflammation - metabolism ; C-Reactive Protein - metabolism ; Aged, 80 and over ; Adult ; Female ; Inflammation - diagnosis ; Enzyme-Linked Immunosorbent Assay ; Risk Factors ; Janus Kinase 2 - genetics ; Survival Rate ; Polycythemia Vera - therapy ; Mutation - genetics ; Thrombocythemia, Essential - blood ; Inflammation - etiology ; Thrombosis - metabolism ; Thrombosis - etiology ; Thrombocythemia, Essential - therapy ; Aged ; Serum Amyloid P-Component - metabolism ; Thrombocythemia, Essential - complications ; Thrombosis - diagnosis ; Index Medicus ; essential thrombocythemia ; Brief Report ; C-reactive protein ; polycythemia vera ; pentraxin 3
    ISSN: 0390-6078
    E-ISSN: 1592-8721
    Source: HighWire Press (Free Journals)
    Source: PubMed Central
    Source: Directory of Open Access Journals
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  • 7
    Language: English
    In: Journal of the American College of Cardiology, 2010, Vol.55 (3), p.198-211
    Description: This meta-analysis was performed to determine the effects of various cholesterol-lowering treatments on the risk of stroke and its relationship with the extent of cholesterol lowering. Statins reduce the incidence of stroke, and it has been proposed that such effect is independent of cholesterol lowering and is explained by alternative mechanisms. We performed a meta-analysis of randomized trials of cholesterol-lowering treatments in cardiovascular disease reporting on stroke, involving 266,973 patients investigated and a cumulative 946,582 person-years of exposure, and a meta-regression analysis of the extent of stroke reduction as a function of changes in total cholesterol. The odds ratio (OR) for the incidence of stroke in actively treated groups versus controls was 0.88 (95% confidence interval: 0.83 to 0.94, p 〈 0.001). No treatment affected fatal strokes. Whereas statins decreased the risk of total stroke significantly (OR: 0.85, 95% confidence interval: 0.78 to 0.92; p 〈 0.001), the benefit of nonstatin interventions was smaller and not statistically significant (diet OR: 0.92, fibrates OR: 0.98, other treatments OR: 0.81). We found a significant relationship between percent reduction of total (and low-density lipoprotein) cholesterol and percent reduction of total strokes (p = 0.0017), with each 1% reduction of total cholesterol predicting a 0.8% relative risk reduction of stroke. We found no significant association between stroke reduction and changes of high-density lipoprotein cholesterol levels, and inconsistent associations with reduction of triglycerides. Among cholesterol-lowering treatments, statins are the most effective at decreasing the risk of total stroke, but their benefit is proportional to the percent reduction of total cholesterol and low-density lipoprotein cholesterol. No lipid-lowering intervention was associated with a reduction of fatal stroke.
    Subject(s): Cardiology. Vascular system ; Neurology ; Biological and medical sciences ; Vascular diseases and vascular malformations of the nervous system ; Medical sciences ; Stroke - blood ; Stroke - prevention & control ; Anticholesteremic Agents - therapeutic use ; Humans ; Triglycerides - blood ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Stroke - epidemiology ; Randomized Controlled Trials as Topic ; Index Medicus ; Abridged Index Medicus
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
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  • 8
    Language: English
    In: The Journal of nutrition, 2018-03-01, Vol.148 (3), p.472-479
    Description: Cognitive decline has been reported following cardiac surgery, leading to great interest in interventions to minimize its occurrence. Long-chain n-3 (ω-3) polyunsaturated fatty acids (PUFAs) have been associated with less cognitive decline in observational studies, yet no trials have tested the effects of n-3 PUFAs on cognitive decline after surgery. We sought to determine whether perioperative n-3 PUFA supplementation reduces postoperative cognitive decline in patients postcardiac surgery. The study comprised a randomized, double-blind, placebo-controlled, multicenter, clinical trial conducted on cardiac surgery recipients at 9 tertiary care medical centers across the United States. Patients were randomly assigned to receive fish oil (1-g capsules containing ≥840 mg n-3 PUFAs as ethyl esters) or placebo, with preoperative loading of 8-10 g over 2-5 d followed postoperatively by 2 g/d until hospital discharge or postoperative day 10, whichever came first. Global cognition was assessed using in-person testing over 30 d with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (primary outcome), Mini-Mental State Exam (secondary outcome), and Trails A and B (secondary outcome) tests. All end points were prespecified. Statistical methods were employed, including descriptive statistics, logistic regression, and various sensitivity analyses. A total of 320 US patients were enrolled in the Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation (OPERA) Cognitive Trial (OCT), a substudy of OPERA. The median age was 62 y (IQR 53, 70 y). No differences in global cognition were observed between placebo and fish oil groups at day 30 (P = 0.32) for the primary outcome, a composite neuropsychological RBANS score. The population demonstrated resolution of initial 4-d cognitive decline back to baseline function by 30 d on the RBANS. Perioperative supplementation with n-3 PUFAs in cardiac surgical patients did not influence cognition ≤30 d after discharge. Modern anesthetic, surgical, and postoperative care may be mitigating previously observed long-term declines in cognitive function following cardiac surgery. This trial was registered at clinicaltrials.gov as NCT00970489.
    Subject(s): Cognitive Dysfunction - rehabilitation ; Perioperative Care ; Double-Blind Method ; Humans ; Middle Aged ; Male ; Cognition - drug effects ; Cognitive Dysfunction - etiology ; Fish Oils - pharmacology ; Neuropsychological Tests ; Fatty Acids, Omega-3 - pharmacology ; Female ; Aged ; Atrial Fibrillation ; Dietary Supplements ; Postoperative Complications ; Heart Diseases - surgery ; Psychological aspects ; Cognitive therapy ; Care and treatment ; Cardiac patients ; Patient outcomes ; Cognition disorders ; Food and nutrition ; Omega-3 fatty acids ; Heart ; Heart surgery ; Polyunsaturated fatty acids ; Cognitive ability ; Clinical trials ; Esters ; Statistical methods ; Cognition ; Prevention ; Fibrillation ; Surgery ; Fish ; Neuropsychology ; Supplementation ; Heart diseases ; Sensitivity analysis ; Statistical analysis ; Fish oils ; Regression analysis ; Health care facilities ; Fatty acids ; Patients ; Ethyl esters ; Population (statistical) ; Cognition & reasoning ; Oils & fats ; Index Medicus ; neuropsychological testing ; cardiac surgery ; brain injury ; cognitive decline ; Ingestive Behavior and Neurosciences ; fish oil
    ISSN: 0022-3166
    E-ISSN: 1541-6100
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: The Lancet (British edition), 2007, Vol.370 (9588), p.667-675
    Description: Summary Background Individuals with diabetes are at higher risk of myocardial infarction than non-diabetics. However, much less is known about the incidence of, and risk factors for, development of diabetes and impaired fasting glucose in patients who have had a myocardial infarction. We set out to estimate this incidence and investigate whether lifestyle factors such as dietary habits might alter this risk. Methods We used prospectively obtained data for 8291 Italian patients with a myocardial infarction within the previous 3 months, who were free of diabetes (determined by medication use, a physician-reported diagnosis, or fasting glucose ≥7 mmol/L) at baseline. Incidence of new-onset diabetes (new diabetes medication or fasting glucose ≥7 mmol/L) and impaired fasting glucose (fasting glucose ≥6·1 mmol/L and 〈7 mmol/L) were assessed at follow-up at 0·5, 1·0, 1·5, 2·5, and 3·5 years. Baseline data for body-mass index (BMI), other risk factors, dietary habits, and medications were updated during follow-up. A Mediterranean diet score was assigned according to consumption of cooked and raw vegetables, fruit, fish, and olive oil. Associations of demographic, clinical, and lifestyle risk-factors with incidence of diabetes and impaired fasting glucose were assessed with multivariable Cox proportional hazards. Findings During 26 795 person-years (mean follow-up 3·2 years [SD 0·9]), 998 individuals (12%) developed new-onset diabetes (incidence 37 cases per 1000 person-years). Of the 7533 without impaired fasting glucose at baseline, 2514 (33%) developed new-onset impaired fasting glucose or diabetes (incidence 123 cases per 1000 person-years), rising to 3859 (62%) of 6229 with the lower cutoff for impaired fasting glucose of 5·6 mmol/L (incidence 321 cases per 1000 person-years). Independent risk factors for new-onset diabetes or impaired fasting glucose included older age, hypertension, use of beta-blockers, lipid-lowering medications (protective), and diuretic use. Independent lifestyle risk-factors included higher BMI, greater BMI gain during follow-up, current smoking, a lower Mediterranean dietary score, and wine consumption of more than 1 L/day. Data for physical activity were unavailable, but inability to perform exercise testing was associated with higher incidence of diabetes and impaired fasting glucose. Interpretation Compared with population-based cohorts, patients with a recent myocardial infarction had a higher annual incidence rate of impaired fasting glucose (1·8 vs 27·5% in our study) and diabetes (0·8–1·6% compared with 3·7%) in this study. Thus, our results indicate that myocardial infarction could be a prediabetes risk equivalent. Smoking cessation, prevention of weight gain, and consumption of typical Mediterranean foods might lower this risk, which emphasises the need for guidance on diet and other lifestyle factors for patients who have had a myocardial infarction.
    Subject(s): Internal Medicine ; Multivariate Analysis ; Life Style ; Glucose Intolerance - epidemiology ; Prospective Studies ; Diet, Mediterranean ; Humans ; Middle Aged ; Risk Factors ; Diabetes Mellitus, Type 2 - prevention & control ; Kaplan-Meier Estimate ; Proportional Hazards Models ; Male ; Diabetes Mellitus, Type 2 - epidemiology ; Incidence ; Myocardial Infarction - complications ; Glucose Intolerance - prevention & control ; Aged, 80 and over ; Adult ; Female ; Italy - epidemiology ; Aged ; Blood sugar monitoring ; Analysis ; Diabetes ; Research ; Health aspects ; Risk factors ; Heart attack ; Index Medicus ; Abridged Index Medicus
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 10
    Language: English
    In: The American heart journal, 2011, Vol.161 (2), p.338-343.e1
    Description: Background The antiarrhythmic effects of n-3 polyunsaturated fatty acids (n-3PUFA) in ischemic heart disease have been demonstrated; however, studies in patients surviving malignant ventricular arrhythmias of different etiologies treated with an implantable cardioverter-defibrillator (ICD) have given conflicting results. The purpose of this study was to assess the antiarrhythmic effect of n-3PUFA versus placebo in 566 patients with heart failure enrolled in the GISSI-HF trial who received an ICD for secondary or primary prevention of ventricular fibrillation (VF) or tachycardia (VT). Methods Clinical data and arrhythmic event recordings extracted from the device memory were obtained. We tested the treatment effect by a multivariate Cox model adjusting for all clinical parameters associated with the primary end point defined as time to first appropriate ICD discharge for VT/VF. Results In the 566 patients with at least one recorded follow-up visit, 1363 VT and 316 VF episodes were terminated by ICD pacing or shock over a median follow-up of 928 days. The incidence of the primary end point event was 27.3% in the n-3PUFA group and 34.0% in the placebo group (adjusted hazard rate = 0.80, 95% CI 0.59-1.09, P = .152). Patients who received 1, 2 to 3, or 〉3 ICD discharges were 8.9%, 7.1%, and 11.1% in the n-3PUFA group, compared with slightly higher rates of 11.1%, 10.7%, and 12.1% in the placebo group (overall P = .30). Patients with the highest 3-month increase in plasma n-3PUFA had a somewhat lower incidence of arrhythmic events. Conclusions The results of this study, though not statistically significant, support prior evidences of an antiarrhythmic effect of n-3PUFA in patients with ICD, although they leave open the issue of whether this effect leads to a survival benefit.
    Subject(s): Cardiovascular ; Cardiology. Vascular system ; Heart ; Cardiac dysrhythmias ; Biological and medical sciences ; Medical sciences ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Tachycardia, Ventricular - therapy ; Heart Failure - complications ; Prospective Studies ; Ventricular Fibrillation - drug therapy ; Tachycardia, Ventricular - drug therapy ; Humans ; Middle Aged ; Tachycardia, Ventricular - etiology ; Male ; Ventricular Fibrillation - etiology ; Defibrillators, Implantable ; Aged, 80 and over ; Fatty Acids, Omega-3 - therapeutic use ; Female ; Aged ; Ventricular Fibrillation - therapy ; Chronic Disease ; Heart failure ; Unsaturated fatty acids ; Care and treatment ; Arrhythmia ; Implants, Artificial ; Prosthesis ; Analysis ; Cardiac patients ; Anti-arrhythmia drugs ; Clinical trials ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-8703
    E-ISSN: 1097-6744
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