RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF FISH-OIL AND MUSTARD OIL IN PATIENTS WITH SUSPECTED ACUTE MYOCARDIAL-INFARCTION - THEINDIAN EXPERIMENT OF INFARCT SURVIVAL .4.

In a randomized, placebo-controlled Mel, the effects of treatment with fish oil (eicosapentaenoic acid, 1.08 g/day) and mustard oil (alpha-l inolenic acid, 2.9 g/day) were compared for 1 year in the management o f 122 patients (fish oil, group A), 120 patients (mustard oil, group B ), and 118 patients (placebo, group C) with suspected acute myocardial infarction (AMI). Treatments were administered about (mean) 18 hours after the symptoms of AMI in all three groups. The extent of cardiac d isease, rise in cardiac enzymes, and lipid peroxides were comparable a mong the groups at entry into the study. After 1 year total cardiac ev ents were significantly less in the fish oil and mustard oil groups co mpared with the placebo group (24.5% and 28% vs. 34.7%,p < 0.01). Nonf atal infarctions were also significantly less in the fish oil and must ard oil groups compared with the placebo group (13.0% and 15.0% vs. 25 .4%,p < 0.05). Total cardiac deaths showed no significant reduction in the mustard oil group; however, the fish oil group had significantly less cardiac deaths compared with the placebo group (11.4% vs. 22.0%, p < 0.05). Apart from the decrease in the cardiac event rate, the fish oil and mustard oil groups also showed a significant reduction in tot al cardiac arrhythmias, left ventricular enlargement, and angina pecto ris compared with the placebo group. Reductions in blood Lipoproteins in the two intervention groups were modest and do not appear to be the cause of the benefit in the two groups. Diene conjugates showed a sig nificant reduction in the fish oil and mustard oil groups, indicating that a part of the benefit may be caused by the reduction in oxidative stress. The findings of this study suggest that fish oil and mustard oil, possibly due to the presence of n-3 fatty acids, may provide rapi d protective effects in patients with AMI. However, a large study is n ecessary to confirm this suggestion.