主持海报环节一:预防与健康政策

B. Rauch, R. Schiele, S. Schneider, H. Gohlke, H. Katus, J. Senges, L. Palmieri, R. Rielli, O. Brignoli, A. Cuffari, P. Ciccarelli, S. Giampaoli
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Giampaoli","doi":"10.1177/17418267100170s201","DOIUrl":null,"url":null,"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. 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引用次数: 0

摘要

B Rauch, R Schiele, S Schneider, H Gohlke, H Katus, J Senges ZAR Ludwigshafen Klinikum,德国莱茵河畔路德维希港门诊康复中心,心脏病学,血管学,神经病学,德国莱茵河畔路德维希港临床中心,心脏病学系,德国路德维希港,海德堡大学心脏病研究中心。主题:对照临床试验背景:Omega-3脂肪酸被认为可有效改善急性心肌梗死后的预后,但目前尚无随机、双盲试验验证其在现行指南调整治疗基础上的预后效果。方法:OMEGA是一项随机、安慰剂对照、双盲、多中心试验,旨在测试OMEGA -3-酸乙酯-90(每天1克,持续一年)对伴有或不伴有st段抬高(STEMI和NSTEMI)的急性心肌梗死幸存者的心源性猝死率、总死亡率和非致命性临床事件的影响,如果在当前指南调整治疗的基础上给予。从2003年10月至2007年6月,患者在心肌梗死后14天随机分组。结果:试验纳入3851例患者(STEMI 59.0%;NSTEMI 41.0%;女性的25.6%;平均年龄64.0岁)。66.5%的患者有高血压病史,49.5%的患者胆固醇水平升高,27%的患者患有糖尿病,36.7%的患者吸烟。93.8%的患者行急性冠状动脉造影,77.8%的患者行急性经皮冠状动脉介入治疗。出院药物包括阿司匹林95.3%、氯吡格雷88.4%、ace抑制剂83.3%、受体阻滞剂94.1%和他汀类药物94.2%。在365天的随访中,事件发生率如下(安慰剂/verum):心源性猝死1.5/1.5%,p1 / 40.84;总死亡率3.7/ 4.6%,p1 / 40.18;幸存者再梗死4.1/4.5%,p1 / 40.63;卒中幸存者为0.7/1.4%,p1 / 40.07。结论:omega试验在选定的德国中心显示了高度的急性心肌梗死指南调整治疗。在这些条件下,omega-3脂肪酸的应用在一年的随访中没有提供额外的预后益处。
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Moderated Poster Session I: Prevention & health policy
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.
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