Omega-3 Polyunsaturated Fatty Acids in Treatment of Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus
Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
*Corresponding author: Gulnara M. Imantaeva, MD, PhD, Associate Professor, Scientific and Research Institute of Cardiology and Internal Diseases, 120, Aiteke Bi str., 050001, Almaty, Kazakhstan Tel: 7-727-2676843. E-Mail: email@example.com
Increased platelet aggregation is one of the major risk factors for cardiovascular events. However, recent studies have demonstrated the inhibition of platelet aggregation by omega-3 PUFAs. The aim of this work was to study the effect of the addition of omega-3 PUFAs to the combination of aspirin and clopidogrel on the platelet aggregation in patients with coronary heart disease. In all, 40 patients with coronary heart disease and diabetes mellitus type 2 undergoing PCI with stent implantation were included in the study. Clopidogrel in a 300 mg loading dose was given after drawing blood for baseline measurement of ADP-induced platelet aggregation. Patients were randomized into two groups. The first group included 20 patients who received 75 mg clopidogrel once daily, 100 mg aspirin once daily and 1000 mg omega-3 PUFAs daily. The second group included 20 patients who received 75 mg clopidogrel once daily and 100 mg aspirin daily. The ADP–induced platelet aggregation was performed twice, once before clopidogrel administration and once after one month. All the patients were genotyped for CYP2C19 polymorphism. No significant differences were noted among the genotype and allele frequencies of the cytochrome CYP2C19 gene between the two groups. The addition of omega-3 PUFAs to the standard dual antiplatelet therapy of aspirin and clopidogrel significantly decreased the ADP-induced platelet aggregation.
- Angiolillo DJ, Fernandez-Ortiz A, Bernardo E, et al Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives. J Am Coll Cardiol 2007; 49:505-1516.
- Smith SC Jr, Allen J, Blair SN, Bonow RO, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update endorsed by the National Heart, Lung, and Blood Institute. J Am Coll Cardiol 2006; 47: 2130-2139.
- Simon T, Verstuyft C, Mary-Krause M, et al Genetic Determinants of Response to Clopidogrel and Cardiovascular Events. N Engl J Med 2009; 360: 363-75.
- GISSI-Prevenzione InvestigatorsDietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI- Prevenzione trial. Lancet1999; 354: 447-55.
- Gajos G, Rostoff P, Undas A, et al. Effects of Polyunsaturated Omega-3 Fatty Acids on Responsiveness to Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention. J Am Coll Cardiol 2010; 55: 1671-1678.
- Hulot J., Bura A., Villard E., Azizi M., Remones V., Goyenvalle C., Aiach M., Lechat P., Gaussem P. Cytochrome P450 2C19 loss-of function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects. Blood 2006; 108: 2244-2247.
- Larson MK, Ashmore JH, Harris KA, et al Effects of omega-3 acid ethyl esters and aspirin, alone and in combination, on platelet function in healthy subjects. Thromb Haemost 100: 634-641, 2008.
- Woodman RJ, Mori TA, Burke V, et al Effects of purified eicosapentaenoic acid and docosahexaenoic acid on platelet, fibrilolytic and vascular function in Type 2 diabetic patients. Atherosclerosis 166: 85-93, 2003.
The fully formatted PDF version is available.
Int J Biomed. 2012; 2(1):31-33. © 2012 International Medical Research and Development Corporation. All rights reserved.