OMEGA-3 ETHYL-ESTER CONCENTRATE DECREASES TOTAL APOLIPOPROTEIN CIII AND INCREASES ANTITHROMBIN-III IN POSTMYOCARDIAL INFARCTION PATIENTS

This study investigated whether an ethyl ester preparation of fish oil (omega-3) could normalise raised plasma concentrations of triglycerid es, apolipoprotein CIII on apolipoprotein B-containing particles (LP C III:B) found in patients with recent acute myocardial infarction. We a lso studied the effect of fish oil on antithrombin III levels. Out of 75 patients with a plasma triglyceride value greater than or equal to 2.0 mmol/L, 22 normalised their triglycerides during diet and were the refore not randomised. The remaining patients were randomly assigned t o 12 weeks' treatment with a daily dose of 4g omega-3 or placebo. Mean plasma triglyceride concentrations were reduced by 24% from 3.10 +/- 1.15 (SD) to 2.53 +/- 0.94 mmol/L (p < 0.001) on omega-3 (p < 0.001 vs placebo). The reduction was due to decreases in very low density lipo protein concentrations. Total apolipoprotein CIII decreased significan tly. This was due to reductions in LP CIII:non B concentrations, but t he ratio LP CIII:non B/LP CIII:B was unaffected because of a slight in significant decrease in LP CIII:B. The plasma triglyceride decreasing effect of omega-3 could therefore not be due to redistribution of CIII between lipoproteins. Low density lipoprotein (LDL) cholesterol incre ased significantly with omega-3 by 7%, and antithrombin III increased significantly with fish oil. In conclusion, omega-3 had a moderate pla sma triglyceride lowering effect and increased LDL cholesterol slightl y, while antithrombin III increased in patients with hypertriglycerida emia who had recently experienced a myocardial infarction.