n-3 Fatty Acids, Ventricular Arrhythmia–Related Events, and Fatal Myocardial Infarction in Postmyocardial Infarction Patients With Diabetes
Article Figures & Tables
Figures
- Figure 1
Kaplan-Meier curves of ventricular arrhythmia–related events (A), death from MI (B), or both end points combined (C). The cumulative incidence of end points is shown in 1,014 patients with an MI and diabetes. Patients were randomly assigned to receive a margarine containing supplemental EPA combined with DHA, a margarine containing supplemental ALA, a margarine containing both EPA-DHA and ALA, or a placebo margarine. P value by log-rank (Mantel-Cox) test.
Tables
- Table 1
Baseline characteristics of the 1,014 patients with an MI and diabetes,* according to n-3 fatty acid supplementation group
Variables Placebo (N = 249) ALA (N = 258) EPA-DHA (N = 262) EPA-DHA plus ALA (N = 245) P value Age (years) 69.1 ± 5.8 69.4 ± 5.7 69.3 ± 5.7 70.0 ± 5.5 0.31 Male sex (%) 197 (79.1) 176 (68.2) 197 (75.2) 177 (72.2) 0.04 Diabetes* Diagnosis from a physician (%) 202 (81.5) 215 (84.0) 212 (80.9) 198 (81.8) 0.81 Use of antidiabetic drugs (%) 184 (73.9) 192 (74.4) 184 (70.2) 180 (73.5) 0.70 Elevated plasma glucose level (%) 115 (46.2) 100 (38.8) 118 (45.0) 108 (44.1) 0.34 Time since MI (years) 4.7 ± 3.2 4.5 ± 3.3 4.4 ± 3.0 4.5 ± 3.1 0.77 Self-reported history of stroke (%) 13 (5.2) 23 (8.9) 18 (6.9) 24 (9.8) 0.22 Use of cardiovascular medication (%) Antithrombotic drugs 241 (96.8) 250 (96.9) 256 (97.7) 234 (95.5) 0.58 Blood pressure–lowering drugs 232 (93.2) 238 (92.2) 247 (94.3) 227 (92.7) 0.82 Lipid-lowering drugs 213 (85.5) 217 (84.1) 223 (85.1) 205 (83.7) 0.93 Antiarrhythmic drugs 11 (4.4) 11 (4.3) 9 (3.4) 9 (3.7) 0.93 Systolic blood pressure (mmHg) 142.1 ± 20.3 143.4 ± 22.5 143.5 ± 21.1 142.6 ± 23.2 0.88 Serum lipids (mmol/L)† Total cholesterol 4.65 ± 0.95 4.65 ± 0.97 4.63 ± 0.92 4.65 ± 1.01 1.00 LDL cholesterol 2.49 ± 0.82 2.40 ± 0.82 2.47 ± 0.78 2.41 ± 0.84 0.63 HDL cholesterol 1.18 ± 0.31 1.22 ± 0.33 1.22 ± 0.36 1.22 ± 0.33 0.51 Triglycerides 2.25 ± 1.35 2.34 ± 1.27 2.13 ± 1.12 2.21 ± 1.20 0.31 BMI‡ Mean 29.2 ± 4.6 29.3 ± 4.3 28.9 ± 4.3 29.4 ± 4.8 0.58 ≥30 (%) 93 (37.5) 97 (37.7) 93 (35.8) 96 (39.2) 0.89 Current smoker (%) 54 (21.7) 44 (17.1) 41 (15.6) 30 (12.2) 0.04 Consumption of ≥1 glass of alcohol/week (%) 165 (66.3) 165 (64.2) 181 (69.1) 155 (63.3) 0.52 Physically active (%)** 40 (16.2) 36 (14.2) 53 (20.4) 47 (19.3) 0.24 Data are means ± SD unless otherwise indicated. As data for a number of patients were missing from several variables (BMI, 4 patients; alcohol use, 1 patient; and physical activity, 9 patients), some percentages are based on a smaller number than the column total.
↵*Diabetes was considered to be present if a patient reported having received the diagnosis from a physician, was taking antidiabetic drugs, or had an elevated plasma glucose level (≥7.0 mmol/L [126 mg/dL] in the case of patients who had fasted more than 4 h or ≥11.1 mmol/L [200.0 mg/dL] in the case of nonfasting patients).
↵†To convert the values for cholesterol to milligrams per deciliter, divide by 0.02586. To convert the values for triglycerides to milligrams per deciliter, divide by 0.01129.
↵‡The BMI is the weight in kilograms divided by the square of the height in meters.
↵**Greater than or equal to three metabolic equivalent of task (indicating at least moderate intensity for at least 30 min/day) during 6 or 7 days/week.
- Table 2
Unadjusted and adjusted HRs of n-3 fatty acid supplementation on end points in 1,014 patients with diabetes, according to n-3 fatty acid supplementation group
Variables Placebo (N = 249) ALA (N = 258) EPA-DHA (N = 262) EPA-DHA plus ALA (N = 245) Ventricular arrhythmia–related events (N = 29) No./total no. (%) 13/249 (5.2%) 6/258 (2.3%) 8/262 (3.1%) 2/245 (0.8%) Crude* 1.0 (ref.) 0.45 (0.17–1.18); 0.10 0.57 (0.24–1.38); 0.21 0.15 (0.04–0.68); 0.01 Adjusted*† 1.0 (ref.) 0.47 (0.18–1.24); 0.13 0.58 (0.24–1.39); 0.22 0.16 (0.04–0.69); 0.01 Death from MI (N = 27) No./total no. (%) 7/249 (2.8%) 11/258 (4.3%) 5/262 (1.9%) 4/245 (1.6%) Crude* 1.0 (ref.) 1.52 (0.59–3.93); 0.39 0.67 (0.21–2.10); 0.49 0.57 (0.17–1.96); 0.38 Adjusted*† 1.0 (ref.) 1.45 (0.56–3.75); 0.45 0.66 (0.21–2.07); 0.47 0.53 (0.15–1.81); 0.31 Ventricular arrhythmia–related events or death from MI (N = 56) No./total no. (%) 20/249 (8.0%) 17/258 (6.6%) 13/262 (5.0%) 6/245 (2.4%) Crude* 1.0 (ref.) 0.82 (0.43–1.57); 0.56 0.60 (0.30–1.21); 0.15 0.30 (0.12–0.74); 0.009 Adjusted*† 1.0 (ref.) 0.81 (0.43–1.56); 0.54 0.60 (0.30–1.20); 0.15 0.28 (0.11–0.71); 0.007 All-cause mortality (N = 110) No./total no. (%) 31/249 (12.4%) 28/258 (10.9%) 26/262 (9.9%) 25/245 (10.2%) Crude* 1.0 (ref.) 0.88 (0.53–1.47); 0.62 0.78 (0.47–1.32); 0.36 0.81 (0.48–1.37); 0.43 Adjusted*† 1.0 (ref.) 0.87 (0.52–1.46); 0.60 0.80 (0.47–1.34); 0.39 0.78 (0.46–1.33); 0.37
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April 2020
Volume 43, Issue 4
