Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Treatment with n-3 polyunsaturated fatty acids after myocardial infarction: results of GISSI-Prevenzione Trial
Autore:
Marchioli, R;
Indirizzi:
Ist Ric Farmacol Mario Negri, Consorzio Mario Negri Sud, ANMCO, Grp Italiano Studio Sopravvivenza Nell Infarto Mi, I-66030 Santa Maria Imbaro, Italy Ist Ric Farmacol Mario Negri Santa Maria Imbaro Italy I-66030 aro, Italy
Titolo Testata:
EUROPEAN HEART JOURNAL SUPPLEMENTS
fascicolo: D, volume: 3, anno: 2001,
pagine: D85 - D97
SICI:
1520-765X(200106)3:D<D85:TWNPFA>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; PLACEBO-CONTROLLED TRIAL; RAT CARDIAC MYOCYTES; RANDOMIZED CONTROLLED TRIAL; LOW-DENSITY-LIPOPROTEIN; VITAMIN-E CONSUMPTION; FISH-OIL; ALPHA-TOCOPHEROL; LONG-CHAIN; CARDIOVASCULAR-DISEASE;
Keywords:
n-3 PUFA; clinical trial; CHD; secondary prevention;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
76
Recensione:
Indirizzi per estratti:
Indirizzo: Marchioli, R GISSI Prevenz Coordinating Ctr, Consorzio Mario Negri Sud, Via Nazl, I-66030 Santa Maria Imbaro, Italy GISSI Prevenz Coordinating Ctr Via Nazl Santa Maria Imbaro Italy I-66030
Citazione:
R. Marchioli, "Treatment with n-3 polyunsaturated fatty acids after myocardial infarction: results of GISSI-Prevenzione Trial", EUR H J SUP, 3(D), 2001, pp. D85-D97

Abstract

GISSI-Prevenzione was conceived as a population, pragmatic trial on patients with recent myocardial infarction conducted in the framework of the Italian public health sysem. In GISSI-Prevenzione, patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive. pharmacological interventions. Long-term n-3 PUFA 1 g daily, but not vitamin E 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall, cardiovascular, cardiac, coronary, and sudden death. At variance from the orientation of a scientific scenario largely dominated by the 'cholesterol-heart hypothesis', GISSI-Prevenzione results indicaten-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction. As to the relevance and comparability of GISSI-Prevenzione results, up to 5-7 lives could be saved per 1000 patients with previous myocardial infarction treated with n-3 PUFA (1 g daily) per year. Such a result is comparableto that observed in the LIPID trial, where 5.2 lives could be saved per 1000 hypercholaesterolemic, CHD patients treated with pravastatin for 1 year. The choice in favour of a relatively low-dose regimen (1 g capsule daily) more acceptable for long-term treatment in a population of patients following Mediterranean dietary habits, the pattern of effects seen in GISSI-Prevenzione (namely, reduction of overall mortality with no decrease in the rateof non-fatal myocardial infarction), all suggest that it can confidently be said that n-3 PUFA treatment should be considered a recommended new component of secondary prevention. The importance of this combined/additive effect is further suggested by the preliminary analyses (to be submitted in thefinal form for publication) of the interplay between diet and n-3 PUFA: there is an interesting direct correlation between size of the effect and 'correctness' of background diets. It can be anticipated that a conceptual barrier must be overcome: a 'dietary drug' should be added to 'dietary advice', which remains fundamental to allow this statement to become true in clinical practice. (C) 2001 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 18:30:53