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Journal of the American College of Nutrition, Vol. 25, No. 6, 480-485 (2006)
Published by the American College of Nutrition

The Triglyceride-Lowering Effects of a Modest Dose of Docosahexaenoic Acid Alone Versus in Combination with Low Dose Eicosapentaenoic Acid in Patients with Coronary Artery Disease and Elevated Triglycerides

Lisa J. Schwellenbach, PharmD, BCPS, Kari L. Olson, PharmD, BCPS, Karen J. McConnell, PharmD, BCPS, Ryan S. Stolcpart, PharmD, BCPS, James D. Nash, Pharm D, BCPS, John A. Merenich, MD, FACP for the Clinical Pharmacy Cardiac Risk Service Study Group

Kaiser Permanente Colorado, School of Pharmacy at Denver
Health Sciences Center
Colorado Permanente Medical Group
University of Colorado Health Sciences Center, Denver, Colorado
Clinical Advisor-Clinical Pharmacy Programs, Humana Inc., Louisville, Kentucky

Address reprint requests to: Kari L. Olson, PharmD, BCPS, Kaiser Permanente Colorado-Clinical Pharmacy Cardiac Risk Service, 16601 East Centretech Parkway, Aurora, CO 80011. E-mail: kari.olson{at}kp.org

Background: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD.

Methods: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL. Subjects were randomized to either 1000 mg of DHA or 1252 mg of DHA + EPA for eight weeks. Baseline and eight-week laboratories were drawn to assess changes in the fasting lipid profile. The primary objective was to evaluate the change in triglycerides between the two groups at eight weeks.

Results: A total of 116 subjects were enrolled; 57 in the DHA group and 59 in the DHA + EPA group. Baseline characteristics were similar between groups. The mean age was 69.4 ± 9.1 years and 70.7% were male. Triglycerides decreased by an average of 21.8% in the DHA group (p < 0.001) and 18.3% in the DHA + EPA group (p < 0.001). The difference between groups was not significant. A greater proportion of subjects in the DHA group achieved triglyceride goal (less than 150 mg/dL) compared to the DHA + EPA group (24.6% versus 10.2%, p < 0.05).

Conclusions: Our results indicate that the American Heart Association recommended cardioprotective dose of omega-3 fatty acids can also significantly lower triglycerides in patients with CAD. There do not appear to be significant differences in triglyceride-lowering between DHA only and DHA + EPA combination products when dosing is based on DHA.

Key words: coronary artery disease, hypertriglyceridemia, omega-3 fatty acids




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