Adding 1.8 grams of omega-3 fatty acids daily to standard treatment after an acute myocardial infarction (AMI) did not appear to reduce the rate of cardiovascular events or all-cause death in elderly patients over a period of two years, according to findings from the OMEMI trial presented Nov. 15 during AHA 2020 and simultaneously published in Circulation.

The multicenter study out of Norway included 1,027 patients (mean age 75, 29% female, mean triglycerides 111.4) with a recent AMI within two to eight weeks. Patients were randomized to either 1.8 grams n-3 polyunsaturated fatty acids (PUFA) or placebo in addition to standard care. The primary endpoint was a composite of nonfatal AMI, unscheduled revascularization, stroke, all-cause death, or heart failure hospitalization after two years. The secondary outcome was new atrial fibrillation, and the safety outcome was major bleeding.

Overall results found no significant difference in the rate of cardiovascular events between the two groups – about 20% for both groups. Additionally, researchers observed no statistical differences between patients in the omega-3 group compared with patients in the placebo group in terms of age, gender, diabetes status, kidney function and triglyceride levels.

The secondary outcome of new atrial fibrillation occurred in nearly twice as many patients in the omega-3 group (7.2%) compared with the placebo group (4.0%). While researchers cautioned the numbers were too small to be of statistical significance, they did raise "concerns with regard to moderate doses of n-3 PUFA supplements and risk of new-onset AFib."

"This study focused on a particularly vulnerable patient group, in this case elderly patients with recent cardiovascular disease and a high load of risk factors, where the effects of preventive measures are usually the most prominent," said Are A. Kalstad, MD, a principal investigator of the study. "The fact that no indication of any impact from the omega-3 fatty acids were found in this group, along with the results of other recent neutral trials, suggests that omega-3 supplements are ineffective for cardiovascular prevention."

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Stable Ischemic Heart Disease, Chronic Angina

Keywords: AHA Annual Scientific Sessions, AHA20, Dyslipidemias, Myocardial Infarction, Angina, Stable, Primary Prevention

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