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Omega-3 fatty acids in heart disease-why accurately measured levels matter.

Authors
  • von Schacky, C1
  • Kuipers, R S2, 3
  • Pijl, H4
  • Muskiet, F A J5
  • Grobbee, D E6
  • 1 Omegametrix, Martinsried, Germany. [email protected]. , (Germany)
  • 2 Heart Centre, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. , (Netherlands)
  • 3 Department of Cardiology, Dijklander Hospital, Purmerend/Hoorn, The Netherlands. , (Netherlands)
  • 4 Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands. , (Netherlands)
  • 5 Department of Laboratory Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. , (Netherlands)
  • 6 Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Netherlands Heart Journal
Publisher
Springer Nature
Publication Date
Nov 01, 2023
Volume
31
Issue
11
Pages
415–423
Identifiers
DOI: 10.1007/s12471-023-01759-2
PMID: 36795219
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Current guidelines barely support marine omega‑3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in cardiology, mainly because results of large trials were equivocal. Most large trials have tested EPA alone or EPA + DHA combined as a drug, thereby disregarding the relevance of their blood levels. These levels are frequently assessed with the Omega‑3 Index (percentage of EPA + DHA in erythrocytes), which is determined using a specific standardised analytical procedure. EPA and DHA are present in every human being at unpredictable levels (even in the absence of intake), and their bioavailability is complex. Both facts need to be incorporated into trial design and should direct clinical use of EPA and DHA. An Omega‑3 Index in the target range of 8-11% is associated with lower total mortality, fewer major adverse cardiac and other cardiovascular events. Moreover, functions of organs such as the brain benefit from an Omega‑3 Index in the target range, while untoward effects, such as bleeding or atrial fibrillation, are minimised. In pertinent intervention trials, several organ functions were improved, with improvements correlating with the Omega‑3 Index. Thus, the Omega‑3 Index is relevant in trial design and clinical medicine, which calls for a widely available standardised analytical procedure and a discussion on possible reimbursement of this test. © 2023. The Author(s).

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