EFFECTS OF MARINE FISH OILS ON THE ANTICOAGULATION STATUS OF PATIENTSRECEIVING CHRONIC WARFARIN THERAPY

The purpose of this placebo-controlled, randomized, double-blinded, pa rallel study was to determine the existence and magnitude of effect of various doses of fish oil supplements on International Normalized Pat io (INR) determinations in patients receiving chronic warfarin therapy . Patients fi om anticoagulation clinics from both the Brady Green Com munity Health Center and Audie L. Murphy Veterans Administration in Sa n Antonio, Texas were enrolled in the study. The enrolled subjects inc luded 5 males and 11 females, all of whom were receiving chronic warfa rin therapy for indications requiring oral anticoagulation. All enroll ed patients underwent a 4-week placebo monitoring period in which INRs were determined on a weekly basis. If the INRs were found to be stabl e, patients were randomized to receive a 4-week treatment period of ei ther placebo capsules (n = 6), 3 grams of fish oil daily (n = 5), or 6 grams of fish oil daily (n = 5). Patients were followed on a twice-we ekly basis for INR determinations and adverse reactions. Five patients were discontinued from the study due to noncompliance (2) and unstabl e INRs (3). There was no statistically significant difference in INRs between the placebo lead-in and treatment period within each group (P = 0.82). There was also no difference in INRs found between groups (P = 0.41). One bruising episode was reported, yet no major bleeding epis odes were observed during the study. Fish oil supplementation in doses of 3-6 grams per day does not seem to create a statistically signific ant effect on the anticoagulation status of patients receiving chronic warfarin therapy.