Patients who are treated with chronic
hemodialysis (HD) experience premature
cardiovascular disease and an increased mortality. N-3
polyunsaturated fatty acids (PUFA) may be effective in the
secondary prevention of
cardiovascular disease, but the effects of
n-3 PUFA has not previously been examined in HD patients. It was hypothesized that
secondary prevention with
n-3 PUFA would reduce the number of cardiovascular events and death in patients who are treated with chronic HD. A randomized, double-blind, placebo-controlled intervention trial compared the effect of
n-3 PUFA and a control treatment as
secondary prevention of cardiovascular events in HD patients. The primary outcome was a composite of total cardiovascular events and death. A total of 206 patients were randomly assigned to treatment with
n-3 PUFA or control treatment and followed for 2 yr or until reaching a predefined end point. During the trial, 121 (59%) of 206 patients reached a primary end point.
N-3 PUFA had no significant effect on the primary composite end point of cardiovascular events and death (62 versus 59; NS). In the
n-3 PUFA group, a significant reduction was seen in the number of
myocardial infarctions (four versus 13; P = 0.036). This trial was limited by a relatively small number of patients and a large number of withdrawals. However, it is concluded that treatment with
n-3 PUFA did not reduce the total number of cardiovascular events and death in this high-risk population.
N-3 PUFA significantly reduced the number of
myocardial infarctions as a secondary outcome, a finding that might be of clinical interest.