Purpose of Review

To examine recently published data from clinical outcome and arteriographic studies that examined the addition of omega-3 fatty acids, eicosapentaenoic acid (EPA) + docosahexanoic acid (DHA), to standard of care therapy on cardiovascular disease (CVD) risk.

Recent Findings

Several trials that tested purified EPA (JELIS, REDUCE-IT, EVAPORATE) were associated with reduced CVD risk and regression of low attenuation coronary plaque volume, whereas studies that employed the combination EPA/DHA (VITAL, OMEMI, STRENGTH) failed to derive clinical benefit.

Summary

Trials testing purified EPA consistently demonstrated reduction in atheromatous volume or CVD events beyond standard of care therapies, whereas the combination of EPA/DHA did not, despite producing similar reductions in triglycerides. Experimental and in vitro data suggest that compared to DHA, EPA exhibits antioxidant, anti-inflammatory, and membrane stabilizing properties that enhance vascular function and CVD risk. Consequently, purified EPA appears to be the treatment of choice for high-risk patients with hypertriglyceridemia.

中文翻译：

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一个可疑的话题：VITAL、REDUCE-IT、STRENGTH 及其他：2021 年将 Omega-3 脂肪酸付诸实践

审查目的

为了检查最近发表的临床结果和动脉造影研究数据，这些研究检查了将 omega-3 脂肪酸、二十碳五烯酸 (EPA) +二十二碳六烯酸 (DHA) 添加到心血管疾病 (CVD) 风险的标准护理疗法中。

最近的发现

几项测试纯化 EPA （ JELIS、REDUCE-IT、EVAPORATE）的试验与降低 CVD 风险和降低低衰减冠状动脉斑块体积有关，而采用 EPA/DHA 组合（VITAL、OMEMI、STRENGTH）的研究未能得出临床益处。

概括

测试纯化的 EPA 的试验一致表明，动脉粥样硬化量或 CVD 事件的减少超过了标准的护理疗法，而 EPA/DHA 的组合则没有，尽管产生了类似的甘油三酯减少。实验和体外数据表明，与 DHA 相比，EPA 具有抗氧化、抗炎和膜稳定特性，可增强血管功能和 CVD 风险。因此，纯化的 EPA 似乎是高甘油三酯血症高危患者的首选治疗方法。