NEJM：Omega-3鱼油不能预防心血管疾病

日前，一项大型研究结果显示，富含Omega-3脂肪酸的鱼油补充剂，对心血管疾病高风险患者可能并没有帮助。该报告发表在了5月9日出版的《新英格兰医学杂志》（New England Journal of Medicine）上。

在2010年，意大利的研究人员开展了这项研究，他们把12513名病人分成两组，一组服用Omega-3补充剂，另一组服用橄榄油安慰剂。

以前的临床试验表明，对于心血管疾病患者或曾经历心跳骤停的患者而言，Omega-3补充剂或可降低心血管疾病的风险。但2010年一项重大的研究发现，鱼油补充剂对预防心房纤维颤动（Atrial fibrillation）没有帮助。

这项最新的研究发现，在服用Omega-3补充剂的和服用橄榄油安慰剂的两组中，都有接近12％的患者经历了中风﹔服用Omega-3的得病率是11.7% ，而安慰剂组是11.9% 。

研究人员表示，许多患有多种心血管疾病危险因素的病人，每天服用Omega-3 治疗，但这项研究发现心血管疾病的死亡率和发病率并未因此降低。

n–3 Fatty Acids in Patients with Multiple Cardiovascular Risk Factors

BACKGROUND

Trials have shown a beneficial effect of n−3 polyunsaturated fatty acids in patients with a previous myocardial infarction or heart failure. We evaluated the potential benefit of such therapy in patients with multiple cardiovascular risk factors or atherosclerotic vascular disease who had not had a myocardial infarction.

METHODS

In this double-blind, placebo-controlled clinical trial, we enrolled a cohort of patients who were followed by a network of 860 general practitioners in Italy. Eligible patients were men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease but not myocardial infarction. Patients were randomly assigned to n−3 fatty acids (1 g daily) or placebo (olive oil). The initially specified primary end point was the cumulative rate of death, nonfatal myocardial infarction, and nonfatal stroke. At 1 year, after the event rate was found to be lower than anticipated, the primary end point was revised as time to death from cardiovascular causes or admission to the hospital for cardiovascular causes.

RESULTS

Of the 12,513 patients enrolled, 6244 were randomly assigned to n−3 fatty acids and 6269 to placebo. With a median of 5 years of follow-up, the primary end point occurred in 1478 of 12,505 patients included in the analysis (11.8%), of whom 733 of 6239 (11.7%) had received n−3 fatty acids and 745 of 6266 (11.9%) had received placebo (adjusted hazard ratio with n−3 fatty acids, 0.97; 95% confidence interval, 0.88 to 1.08; P=0.58). The same null results were observed for all the secondary end points.

CONCLUSIONS

In a large general-practice cohort of patients with multiple cardiovascular risk factors, daily treatment with n−3 fatty acids did not reduce cardiovascular mortality and morbidity. (Funded by Società Prodotti Antibiotici and others; ClinicalTrials.gov number,