Diet and Reinfarction Trial

At low doses, PUFAs provide protection against coronary heart disease and reduce the severity of cardiac arrhythmias at high doses, they lower blood cholesterol and triglycerides, reduce platelet aggregation, have antithrombotic activity, and reduce blood viscosity. Several clinical studies have reported beneficial effects of supplementation on mortality, sudden death, and arrhythmias. In the Diet and Reinfarction Trial (DART), the use of fatty fish or fish oil led to a 29% reduction in mortality, and the GlSSI-Preven-zione trial showed that consumption of 1 g n-3-PUFA daily resulted in a 20% decrease in mortality and 45%i reduction in sudden death. ° ... 

Li, Y, Kang, J.X., and Leaf, A., Differential effects of various eicosanoids on the contraction of cultured neonatal rat cardiomyocytes. Prostaglandins, 54, 511, 1997. Burr, M.L., et al.. Effect of changes in fat, fish and fibre intakes on death and myocardial reinfarction diet and reinfarction trial (DART), Lancet, 2, 757, 1989. 

Survival Between 6 and 12 Months Post-Myocardial Infarction in the Diet and Reinfarction Trial (DART) "Fish Advice" Group ... 

Burr, M.L., Fehily, A.M., Gilbert, J.F., Rogers, S., Holliday, R.M., Sweetnam, RM., Elwood, RC., and Deadman, N.M. (1989) Effects of Changes in Fat, Fish, and Fibre Intakes on Death and Myocardial Reinfarction Diet and Reinfarction Trial (DART), Lancet 2,757-761. 

Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction Diet And Reinfarction Trial (DART). Lancet 1989 334(8666) 757-61. 

Do marine n-3 oils make any real difference as to whether we will suffer from fewer adverse cardiac events The first prospective study to explore the cardioprotective effect of n-3 fatty acids in a secondary prevention trial was the Diet and Reinfarction Trial. Burr et al (1989) studied 2013 men who had survived a heart attack. Half were advised to eat oily fish twice a week or to take marine n-3 oil capsules giving an equivalent amount of n-3 fatty acid as the fish diet, while the other half were advised only to eat a prudent diet. Survival over the following 2 years was monitored. The group advised to consume oily... 

In the UK diet and reinfarction trial, 2-year mortality was reduced by 29% in survivors of a first myocardial infarction in those receiving advice to consume fatty fish at least twice a week. A meta-analysis of 13 large cohort studies su ests a protective effect of fish intake against CHD. Compared with those who never consumed fish or did so less than once a month, persons who ate fish had a lower risk of CHD (38% lower for 5 or more times a week, 23% lower for 2-4 times a week, 15% lower for once a week, and 11% lower for 1-3 times a month). Each 20 g day increase in fish consumption was related to a 7% lower risk of CFID. 

The antiarrhythmic effects of n-3 fatty acids are supported by clinical intervention trials (Diet and Reinfarction Trial (DART), Lyon Heart Study, Gruppo Italiano per lo Studio della Soprawivenza nellTnfarto miocardico (GlSSI)-Prevenzione Trial, Indo-Mediterranean Diet Heart Study). Their results strongly support the role of fish or fish oil in decreasing total mortality and sudden death in patients with one episode of myocardial infarction. Therefore, the addition of 1 g/d of n-3 fatty acids is highly recommended for the primary and secondary prevention of coronary heart disease. 

In a controlled clinical trial which involved a study of 206 experimental and 206 control male patients a plasma cholesterol-lowering diet was reported to reduce the incidence of cardiac reinfarction without affecting the incidence of sudden death [30]. 

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