Moderated Poster Session I: Prevention & health policy

Abstract

P13 Prognostic effect of omega-3 fatty acid supplementation on top of current guideline adjusted therapy of acute myocardial infarction the OMEGA trial B Rauch, R Schiele, S Schneider, H Gohlke, H Katus, J Senges ZAR Ludwigshafen Klinikum, Center for Ambulatory Rehabilitation, Cardiology, Angiology, Neurology, Ludwigshafen am Rhein, Germany, Clinical Center of Ludwigshafen, Department of Cardiology, Ludwigshafen amRhein, Germany, Heart Attack Research Center at the University of Heidelberg, Ludwigshafen am Rhein, Germany, Heart Centre Bad Krozingen, Bad Krozingen, Germany, University Hospital Heidelberg, Internal Medicine III, Department of Cardiology, Angiology and Pneumology, Heidelberg, Germany Topic: Controlled clinical trials Background:Omega-3 fatty acids are regarded to be effective in improving prognosis after acute myocardial infarction, but there is no randomized, double blind trial testing their prognostic effect on top of current, guideline adjusted treatment. Methods: OMEGA is a randomized, placebo-controlled, double blind, multicenter trial to test the effects of omega-3-acid ethyl esters-90 (one gram per day for one year) on the rate of sudden cardiac death, total mortality, and non fatal clinical events in survivors of acute myocardial infarction with and without ST-elevation (STEMI and NSTEMI), if given on top to current guideline adjusted treatment. Patients were randomized 3 14 days after myocardial infarction from October 2003 until June 2007. Results: The trial included 3,851 patients (STEMI 59,0%; NSTEMI 41.0%; female 25.6%; mean age 64.0 years). From these patients 66.5% had a history of hypertension, 49.5% had elevated cholesterol levels, 27% had diabetes, and 36.7% were smokers. Acute coronary angiography was performed in 93.8%, acute percutaneous coronary intervention in 77.8% of all patients. Discharge medication included aspirin 95.3%, clopidogrel 88.4%, ACE-inhibitors 83.3%, beta-blockers 94.1%, and statins 94.2%. Duringthe follow-up of 365 days the event rates were as follows (placebo/verum): sudden cardiac death 1.5/1.5%, p1⁄40.84; total mortality 3.7/ 4.6%, p1⁄40.18; reinfarction in survivors 4.1/4.5%, p1⁄40.63; stroke in survivors 0.7/1.4%, p1⁄40.07. Conclusion: The OMEGA-trial demonstrates a high degree of guideline adjusted treatment of acute myocardial infarction in selected German centers. Under these conditions on top application of omega-3 fatty acids did not provide an additional prognostic benefit within one year of follow-up.