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  • 1
    Language: English
    In: The American journal of cardiology, 2011, Vol.108 (6), p.851-856
    Description: An open-label study reported that ingestion of a fish oil concentrate decreased the incidence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) surgery. However, a general cardiac surgery population involves valve and CABG surgeries. We undertook a double-blinded randomized controlled trial to examine the effectiveness of fish oil supplementation on the incidence of postsurgical AF after CABG and valve procedures. The primary end point was incidence of AF in the first 6 days after surgery. Two hundred patients were randomized to receive fish oil (providing 4.6 g/day of long-chain ω-3 fatty acids) or a control oil starting 3 weeks before surgery; 194 subjects completed the study, with 47 of 97 subjects in the control group and 36 of 97 subjects in the fish oil group developing AF (odds ratio 0.63, 95% confidence interval [CI] 0.35 to 1.11). There was a nonstatistically significant delay in time to onset of AF in the fish oil group (hazard ratio 0.66, 95% CI 0.43 to 1.01). There was a significant decrease in mean length of stay in the intensive care unit in the fish oil group (ratio of means 0.71, 95% CI 0.56 to 0.90). In conclusion, in a mixed cardiac surgery population, supplementation with dietary fish oil did not result in a significant decrease in the incidence of postsurgical AF. However, there was a significant decrease in time spent in the intensive care unit.
    Subject(s): Cardiovascular ; Cardiology. Vascular system ; Heart ; Diseases of the digestive system ; Cardiac dysrhythmias ; Biological and medical sciences ; Medical sciences ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Surgery of the heart ; Prospective Studies ; Double-Blind Method ; Humans ; Middle Aged ; Postoperative Complications - prevention & control ; Proportional Hazards Models ; Intensive Care Units - statistics & numerical data ; Logistic Models ; Male ; Treatment Outcome ; Fish Oils - therapeutic use ; Incidence ; Cardiac Surgical Procedures ; Placebos ; Female ; Aged ; Dietary Supplements ; Atrial Fibrillation - prevention & control ; Length of Stay - statistics & numerical data ; Heart beat ; Management science ; Coronary artery bypass ; Analysis ; Atrial fibrillation ; Dietary supplements ; Cardiology ; Fatty acids ; Public health ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9149
    E-ISSN: 1879-1913
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
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  • 2
    Language: English
    In: The American journal of cardiology, 2008, Vol.101 (6), p.758-761
    Description: Increased consumption of fish and/or fish oil was associated with decreased risk of sudden cardiac death (SCD). The study aim was to evaluate the antiarrhythmic effect of dietary fish oil on the inducibility of ventricular tachycardia (VT) at high risk of SCD. Patients with coronary artery disease undergoing defibrillator implantation were recruited if sustained monomorphic VT could be induced by programmed extra stimuli at 2 cycle lengths. After the initial study, 12 patients consumed 3 g/d of encapsulated fish oil for approximately 6 weeks before a repeated electrophysiologic study. To control for fluctuations in the inducibility of VT, an additional 14 patients with no dietary manipulation were also studied. Aggressiveness of stimulation required to induce VT was ranked from least aggressive to most aggressive based on cycle length and number of extra stimuli, with noninducibility ranked highest. At the repeated electrophysiologic study, in the fish-oil group, 42% had no inducible VT, 42% required more aggressive stimulation to induce VT, 8% required identical stimulation, and 8% required less stimulation compared with 7%, 36%, 36%, and 21% in the control group, respectively. Overall, there was a change to noninducible or less inducible VT in the fish-oil group, but no change in the control group (p = 0.003 and p = 0.65, respectively; Wilcoxon’s sign-rank test). In conclusion, dietary n-3 fatty acid supplementation decreased the inducibility of VT in patients at risk of SCD. These findings suggest that dietary fish oil can have an antiarrhythmic effect.
    Subject(s): Cardiovascular ; Cardiology. Vascular system ; Heart ; Biological and medical sciences ; Myocarditis. Cardiomyopathies ; Medical sciences ; Cardiac dysrhythmias ; Prospective Studies ; Follow-Up Studies ; Death, Sudden, Cardiac - epidemiology ; Humans ; Middle Aged ; Tachycardia, Ventricular - etiology ; Death, Sudden, Cardiac - prevention & control ; Male ; Treatment Outcome ; Tachycardia, Ventricular - prevention & control ; Fish Oils - therapeutic use ; Tachycardia, Ventricular - mortality ; Myocardial Ischemia - complications ; Fatty Acids, Omega-3 - therapeutic use ; Heart Rate - physiology ; Female ; Myocardial Ischemia - diet therapy ; Myocardial Ischemia - mortality ; Unsaturated fatty acids ; Care and treatment ; Cardiac patients ; Anti-arrhythmia drugs ; Dietary supplements ; Ventricular tachycardia ; Coronary heart disease ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9149
    E-ISSN: 1879-1913
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 3
    Language: English
    In: Annals of the rheumatic diseases, 2015-01, Vol.74 (1), p.89-95
    Description: Background The effects of fish oil (FO) in rheumatoid arthritis (RA) have not been examined in the context of contemporary treatment of early RA. This study examined the effects of high versus low dose FO in early RA employing a ‘treat-to-target’ protocol of combination disease-modifying anti-rheumatic drugs (DMARDs). Methods Patients with RA 〈12 months’ duration and who were DMARD-naïve were enrolled and randomised 2:1 to FO at a high dose or low dose (for masking). These groups, designated FO and control, were given 5.5 or 0.4 g/day, respectively, of the omega-3 fats, eicosapentaenoic acid + docosahexaenoic acid. All patients received methotrexate (MTX), sulphasalazine and hydroxychloroquine, and DMARD doses were adjusted according to an algorithm taking disease activity and toxicity into account. DAS28-erythrocyte sedimentation rate, modified Health Assessment Questionnaire (mHAQ) and remission were assessed three monthly. The primary outcome measure was failure of triple DMARD therapy. Results In the FO group, failure of triple DMARD therapy was lower (HR=0.28 (95% CI 0.12 to 0.63; p=0.002) unadjusted and 0.24 (95% CI 0.10 to 0.54; p=0.0006) following adjustment for smoking history, shared epitope and baseline anti–cyclic citrullinated peptide. The rate of first American College of Rheumatology (ACR) remission was significantly greater in the FO compared with the control group (HRs=2.17 (95% CI 1.07 to 4.42; p=0.03) unadjusted and 2.09 (95% CI 1.02 to 4.30; p=0.04) adjusted). There were no differences between groups in MTX dose, DAS28 or mHAQ scores, or adverse events. Conclusions FO was associated with benefits additional to those achieved by combination ‘treat-to-target’ DMARDs with similar MTX use. These included reduced triple DMARD failure and a higher rate of ACR remission.
    Subject(s): Hydroxychloroquine - therapeutic use ; Sulfasalazine - therapeutic use ; Blood Sedimentation ; Double-Blind Method ; Arthritis, Rheumatoid - blood ; Humans ; Middle Aged ; Male ; Treatment Outcome ; Eicosapentaenoic Acid - administration & dosage ; Methotrexate - therapeutic use ; Docosahexaenoic Acids - administration & dosage ; Remission Induction ; Arthritis, Rheumatoid - drug therapy ; Early Medical Intervention ; Adult ; Female ; Fish Oils - administration & dosage ; Aged ; Isoxazoles - therapeutic use ; Drug Therapy, Combination ; Antirheumatic Agents - therapeutic use ; Usage ; Care and treatment ; Antirheumatic agents ; Fish oils ; Rheumatoid arthritis ; Clinical trials ; Dosage and administration ; Health aspects ; Risk factors ; Studies ; Fatty acids
    ISSN: 0003-4967
    E-ISSN: 1468-2060
    Source: Alma/SFX Local Collection
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  • 4
    Language: English
    In: Journal of the American College of Cardiology, 2013, Vol.61 (21), p.2194-2196
    Subject(s): Cardiovascular ; Internal Medicine ; Sects ; Medical colleges ; Hospitals ; Heart beat ; Atrial fibrillation
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
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  • 5
    Language: English
    In: British journal of nutrition, 2014-09-14, Vol.112 (5), p.812-820
    Description: Randomised controlled trials (RCT) examining the effects of fish oil supplementation on cardiac outcomes have yielded varying results over time. Although RCT are placed at the top of the evidence hierarchy, this methodology arose in the framework of pharmaceutical development. RCT with pharmaceuticals differ in important ways from RCT involving fish oil interventions. In particular, in pharmaceutical RCT, the test agent is present only in the intervention group and not in the control group, whereas in fish oil RCT, n-3 fats are present in the diet and in the tissues of both groups. Also, early phase studies with pharmaceuticals determine pharmacokinetics and pharmacodynamics to design the dose of the RCT intervention so that it is in a predicted linear dose–response range. None of this happens in fish oil RCT, and there is evidence that both baseline n-3 intake and tissue levels may be sufficiently high in the dose–response range that it is not possible to demonstrate a clinical effect with a RCT. When these issues are considered, it is possible that the changing pattern of fish consumption and fish oil use over time, especially in cardiac patients, can explain the disparity where benefit was observed in the early fish oil trials but not in the more recent trials.
    Subject(s): Full Papers ; Dietary Surveys and Nutritional Epidemiology ; Fundamental and applied biological sciences. Psychology ; Feeding. Feeding behavior ; Biological and medical sciences ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Humans ; Erythrocytes - chemistry ; Fish Oils - analysis ; Fatty Acids, Omega-3 - analysis ; Randomized Controlled Trials as Topic ; Dose-Response Relationship, Drug ; Eicosapentaenoic Acid - blood ; Docosahexaenoic Acids - blood ; Diet ; Fish Oils - administration & dosage ; Heart Diseases - drug therapy ; Pharmaceutical Preparations ; Fatty Acids, Omega-3 - administration & dosage ; Index Medicus
    ISSN: 0007-1145
    E-ISSN: 1475-2662
    Source: Alma/SFX Local Collection
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  • 6
    Language: English
    In: British journal of nutrition, 2015-09-28, Vol.114 (6), p.885-890
    Description: A randomised controlled trial (RCT) of high-dose v. low-dose fish oil in recent-onset rheumatoid arthritis (RA) demonstrated that the group allocated to high-dose fish oil had increased remission and decreased failure of disease-modifying anti-rheumatic drug (DMARD) therapy. This study examines the relationships between plasma phospholipid levels of the n-3 fatty acids in fish oil, EPA and DHA, and remission and DMARD use in recent-onset RA. EPA and DHA were measured in blood samples from both groups of the RCT. The data were analysed as a single cohort, and Cox proportional hazards models were used to examine relationships between plasma phospholipid (PL) EPA and DHA and various outcome measures. When analysed as a single cohort, plasma PL EPA was related to time to remission, with a one unit increase in EPA (1 % total fatty acids) associated with a 12 % increase in the probability of remission at any time during the study period (hazard ratio (HR)=1·12; 95 % CI 1·02, 1·23; P=0·02). Adjustment for smoking, anti-cyclic citrullinated peptide antibodies and ‘shared epitope’ HLA-DR allele status did not change the HR. Plasma PL EPA, adjusted for the same variables, was negatively related to time to DMARD failure (HR=0·85; 95 % CI 0·72, 0·99; P=0·047). The HR for DHA and time to remission or DMARD failure were similar in magnitude to those for EPA, but not statistically significant. Biomarkers of n-3 status, such as plasma PL EPA, have the potential to predict clinical outcomes relevant to standard drug treatment of RA patients.
    Subject(s): Full Papers ; Nutritional Immunology ; Follow-Up Studies ; Antirheumatic Agents - administration & dosage ; Arthritis, Rheumatoid - blood ; Humans ; Middle Aged ; Male ; Eicosapentaenoic Acid - administration & dosage ; Fish Oils - therapeutic use ; Arthritis, Rheumatoid - drug therapy ; Adult ; Autoantibodies - analysis ; Female ; Fish Oils - administration & dosage ; Phospholipids - blood ; Drug Resistance ; Antirheumatic Agents - therapeutic use ; Docosahexaenoic Acids - therapeutic use ; Double-Blind Method ; Proportional Hazards Models ; Phospholipids - chemistry ; Combined Modality Therapy ; Biomarkers - blood ; Docosahexaenoic Acids - administration & dosage ; Remission Induction ; Docosahexaenoic Acids - analysis ; Arthritis, Rheumatoid - diet therapy ; Eicosapentaenoic Acid - blood ; Docosahexaenoic Acids - blood ; Peptides, Cyclic - antagonists & inhibitors ; Aged ; Eicosapentaenoic Acid - therapeutic use ; Arthritis, Rheumatoid - immunology ; Eicosapentaenoic Acid - analysis ; Dietary Supplements ; Cohort Studies ; Index Medicus
    ISSN: 0007-1145
    E-ISSN: 1475-2662
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: Clinical endocrinology (Oxford), 2016-09, Vol.85 (3), p.369-377
    Description: Summary Objective Corticosteroid‐binding globulin (CBG), the cortisol transport protein, is cleaved from high‐affinity (haCBG) to low‐affinity (laCBG) CBG at sites of inflammation releasing bioavailable, anti‐inflammatory cortisol. Rheumatoid arthritis (RA) is a glucocorticoid‐responsive disorder, with paradoxically normal cortisol levels despite elevated inflammatory mediators. Our objective was to determine whether CBG cleavage relates to RA disease activity. We hypothesized that impaired CBG cleavage may limit delivery of free cortisol to inflamed joints in RA. Design Prospective, cross‐sectional observational study. Setting and Participants Fifty‐three patients with RA recruited from a Rheumatology outpatient clinic at a tertiary referral centre in Adelaide, Australia, and 73 healthy controls. Measurements Total CBG, haCBG and laCBG, total, free and salivary cortisol, inflammatory markers including interleukin‐6 soluble receptor (IL‐6sR) and macrophage migration inhibitory factor and clinical measures of disease activity. Results Among patients with RA, a wide range of disease activity scores was observed (DAS28: range 1·2–6·4). laCBG was lower in patients with RA (mean ± SEM); 153 ± 9, compared with healthy controls; 191 ± 8 nmol/l, P = 0·003. Levels of total and haCBG were higher in patients with more severe RA disease activity. Free and total cortisol, free cortisol:IL‐6sR ratio and total cortisol:IL‐6sR ratio correlated negatively with disease activity. Conclusions These results suggest that patients with RA have reduced CBG cleavage compared to healthy controls and that cleavage is reduced further with higher RA disease activity. Hence, impaired CBG‐mediated delivery of endogenous cortisol may perpetuate chronic inflammation in RA.
    Subject(s): Receptors, Interleukin-6 - analysis ; Severity of Illness Index ; Transcortin - metabolism ; Prospective Studies ; Cross-Sectional Studies ; Hypothalamo-Hypophyseal System - pathology ; Humans ; Middle Aged ; Hydrocortisone - metabolism ; Male ; Pituitary-Adrenal System - pathology ; Inflammation - etiology ; Case-Control Studies ; Arthritis, Rheumatoid - pathology ; Transcortin - analysis ; Arthritis, Rheumatoid - metabolism ; Inflammation - metabolism ; Hydrocortisone - analysis ; Aged, 80 and over ; Adult ; Female ; Aged ; Arthritis, Rheumatoid - diagnosis ; Rheumatoid factor ; Arthritis ; Corticosteroids ; Clinics ; Interleukins ; Index Medicus
    ISSN: 0300-0664
    E-ISSN: 1365-2265
    Source: Alma/SFX Local Collection
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  • 8
    Language: English
    In: The American journal of clinical nutrition, 2010, Vol.91 (3), p.528-534
    Description: Studies relating cardiovascular outcomes to dietary or blood measures of various fatty acids rely on the implicit assumptions that dietary change results in changes in blood fatty acids that, in turn, alter cardiac fatty acids. Although dietary intakes of n-3 (omega-3), n-6 (omega-6), and trans fatty acids are reflected in their concentrations in blood, there are few human data on the relation between blood and cardiac concentrations of fatty acids. The objective was to explore relations between blood and myocardial n-3, n-6, trans, monosaturated, and saturated fatty acids over a range of community intakes to evaluate whether blood fatty acids are useful surrogate markers of their cardiac counterparts. Patients undergoing on-pump coronary bypass surgery were recruited. Right atrial appendages and blood were collected at surgery for fatty acid analysis. Atrial appendages and matching blood samples were collected from 61 patients. Highly significant correlations were identified between atrial and erythrocyte or plasma n-3 [eg, eicosapentaenoic acid (erythrocytes: r = 0.93, P 〈 0.0001; plasma: r = 0.87, P 〈 0.0001)], some n-6 [eg, arachidonic acid (erythrocytes: r = 0.45, P = 0.0003; plasma: r = 0.39, P = 0.002)], trans [eg, total trans 18:1 (erythrocytes: r = 0.89, P 〈 0.0001; plasma: r = 0.74, P 〈 0.0001)], and monounsaturated [eg, oleic acid (erythrocytes: r = 0.37, P = 0.003)] fatty acids. There were no statistical associations between blood and cardiac saturated fatty acids. Erythrocyte- and plasma phospholipid-derived fatty acids can be used to estimate cardiac fatty acid status in humans.
    Subject(s): Fundamental and applied biological sciences. Psychology ; Feeding. Feeding behavior ; Biological and medical sciences ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Dietary Fats - metabolism ; Reproducibility of Results ; Atrial Appendage - metabolism ; Humans ; Middle Aged ; Male ; Biomarkers - blood ; Dietary Fats - blood ; Regression Analysis ; Diet ; Myocardium - metabolism ; Erythrocytes - metabolism ; Coronary Artery Bypass ; Female ; Aged ; Nutritional Status ; Fatty Acids - blood ; Fatty Acids - metabolism ; Research ; Coronary artery bypass ; Health aspects ; Saturated fatty acids ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9165
    E-ISSN: 1938-3207
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: The American journal of clinical nutrition, 2007, Vol.85 (5), p.1222-1228
    Description: Increased fish or fish-oil consumption is associated with reduced risk of cardiac mortality, especially sudden death. This benefit putatively arises from the incorporation of the long-chain n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) into cardiomyocyte phospholipids. The study examined the kinetics of incorporation of n-3 fatty acids into human myocardial membrane phospholipids during supplementation with fish oil and alpha-linolenic acid-rich flaxseed oil. Patients with low self-reported fish intake (〈1 fish meal/wk and no oil supplements) accepted for elective cardiac surgery involving cardiopulmonary bypass were randomly allocated to 1 of 6 groups: no supplement; fish oil (6 g EPA+DHA/d) for either 7, 14, or 21 d before surgery; flaxseed oil; or olive oil (both 10 mL/d for 21 d before surgery). Right atrial appendage tissue removed during surgery and blood collected at enrollment and before surgery were analyzed for phospholipid fatty acids. Surgery rescheduling resulted in a range of treatment times from 7 to 118 d. In the fish-oil-treated subjects, accumulation of EPA and DHA in the right atrium was curvilinear with time and reached a maximum at approximately 30 d of treatment and displaced mainly arachidonic acid. Flaxseed oil supplementation yielded a small increase in atrial EPA but not DHA, whereas olive oil did not significantly change atrial n-3 fatty acids. The results of the present study show that dietary n-3 fatty acids are rapidly incorporated into human myocardial phospholipids at the expense of arachidonic acid during high-dose fish-oil supplementation.
    Subject(s): Fundamental and applied biological sciences. Psychology ; Feeding. Feeding behavior ; Biological and medical sciences ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Humans ; Middle Aged ; Male ; Eicosapentaenoic Acid - administration & dosage ; Olive Oil ; Membrane Lipids - chemistry ; Myocardium - metabolism ; Cardiovascular Diseases - mortality ; Female ; Fish Oils - administration & dosage ; Phospholipids - metabolism ; Plant Oils - administration & dosage ; Fatty Acids, Omega-3 - metabolism ; Cardiovascular Diseases - metabolism ; Risk Factors ; Phospholipids - chemistry ; Cardiopulmonary Bypass ; Docosahexaenoic Acids - administration & dosage ; Docosahexaenoic Acids - pharmacokinetics ; Cardiovascular Diseases - surgery ; Linseed Oil - chemistry ; Myocardium - cytology ; Fatty Acids, Omega-3 - pharmacokinetics ; Eicosapentaenoic Acid - pharmacokinetics ; Membrane Lipids - metabolism ; Aged ; Dietary Supplements ; Fish Oils - chemistry ; Plant Oils - chemistry ; Linseed Oil - administration & dosage ; Adipose tissues ; Physiological aspects ; Research ; Fish oils ; Health aspects ; Heart muscle ; Index Medicus ; Abridged Index Medicus
    ISSN: 0002-9165
    E-ISSN: 1938-3207
    Source: Alma/SFX Local Collection
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  • 10
    Language: English
    In: Journal of the American College of Cardiology, 2013-05-28, Vol.61 (21), p.2194-2196
    Subject(s): Humans ; Atrial Fibrillation - etiology ; Cardiac Surgical Procedures - adverse effects ; Postoperative Care - methods ; Postoperative Complications ; Atrial Fibrillation - prevention & control ; Fish Oils - therapeutic use ; Randomized Controlled Trials as Topic ; Index Medicus ; Abridged Index Medicus
    ISSN: 0735-1097
    E-ISSN: 1558-3597
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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