Interventional Cardiologist Eyes Benefits Of Omega-3 Fatty Acids

NEW MILFORD — If you survive a heart attack in Italy, chances are your doctor would give you a prescription for purified fish oil, or omega-3 fatty acids. For most Americans who share the same fate, this drug is rarely recommended when returning home from a hospital’s cardiac unit. Lawrence Laifer, MD, director of Cardiac Catheterization and Interventional Cardiology at New Milford Hospital, wants that to change.

“In most of Europe, heart attack victims are typically discharged with a prescription to take fish oil, among other recommendations to reduce health risk factors. Fish oil has been widely studied there, and is clearly recommended in international guidelines for people diagnosed with cardiovascular disease,” said Dr Laifer, who is also faculty member at Columbia University College of Physicians and Surgeons.

In several key studies, Dr Laifer explained, prescription fish oil has been shown to improve survival after heart attacks and to reduce fatal heart rhythms.

As a specialist treating acute heart disease, Dr Laifer said that US hospitals routinely offer more expensive and invasive treatments, like pills to lower cholesterol, angioplasty or implantable defibrillators, but generally do not give emphasize omega-3 fatty acids as part of a total risk reduction regimen. “We cannot discount the many appropriate and life-saving cardiac treatment options available, but we can do more to prevent subsequent heart attacks and sudden death from heart disease. As a nation, we are not taking full advantage of the body of knowledge touting the benefits of fish oil.”

While sold over the counter as a dietary supplement, prescription fish oil (manufactured under the brand name Lovaza) is not approved by the Food and Drug Administration for use in heart patients. It is not licensed to prevent heart disease; therefore, drug companies cannot legally promote it for that purpose. In addition, the fact that fish oil is sold as a nutritional supplement has made it harder for some physicians to regard it as a powerful drug.

“Many physicians, including some cardiologists, may consider omega-3s as just a dietary intervention, but they are much more than that. I would encourage all patients with heart disease to discuss this option with their doctors, just as they discuss other medications and supplements to keep their doctor fully informed about their health,” Dr Laifer added.

While some gaps exist in the debate over fish oil for the masses, the case has strengthened for its use among people with known cardiovascular disease.

In the widely known Gissi-Prevention Study, Italian researchers gave more than 11,000 patients one gram of prescription fish oil a day after heart attacks. After three years, the study found that the number of deaths was reduced by 20 percent and that the number of sudden deaths by 45 percent, compared with a control group. Additional studies have yielded positive results, suggesting that the consumption of omega fatty acids provides a protective effect for those at greatest risk.

In 2006, the American College of Cardiology strengthened its position on the medical benefits of fish oil, but some critics say that studies have not defined the magnitude of the effect. The college now advises patients with coronary artery disease to increase their consumption of omega-3 fatty acids to one gram a day, but it does not specify if this should be achieved by eating fish or taking capsules.

Even the FDA has advised that intakes of up to 3 grams/day of marine omega-3 fatty acids are generally recognized as safe for inclusion in the diet, and approved a qualified health claim for the inclusion of some omega-3 fatty acids in supplements such as multivitamins. These developments further support dietary guidelines of the American Heart Association, which call for at least two servings of fatty fish per week.

“Hundreds of studies support the consensus that fish oil consumption reduces sudden cardiac death and death from cardiovascular disease,” Dr Laifer said.