University of Chicago Pritzker School of Medicine, Chicago, IL 60654, USA.
Curr Opin Lipidol. 2011 Dec;22(6):437-44. doi: 10.1097/MOL.0b013e32834bd642.
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been attributed with several health benefits, including triglyceride lowering and cardiovascular disease risk reduction. This review focuses on new prescription omega-3 fatty acid products in development and recently published data regarding omega-3 fatty acid effects on arrhythmias, heart failure, and platelet inactivation.
A free fatty acid form of n-3 PUFA was found to produce a four-fold higher area under the plasma n-3 PUFA curve than prescription omega-3-acid ethyl esters in patients on a low-fat diet. Eicosapentaenoic acid ethyl esters reduced triglyceride without significantly elevating LDL cholesterol in patients with severe hypertriglyceridemia and in those with mixed dyslipidemia. Recent investigations of n-3 PUFA effects on ventricular and atrial arrhythmias, including studies in patients with implanted defibrillators, failed to demonstrate a significant benefit. However, increased fatty fish or n-3 PUFA consumption was associated with a lower rate of hospitalization in heart failure patients. A further important finding was potentiation of the antiplatelet response when n-3 PUFAs were added to aspirin + clopidogrel.
Although n-3 PUFA therapy continues to show promise in the prevention and management of cardiovascular diseases, further research is necessary to more fully elucidate its role in specific disorders.
ω-3 多不饱和脂肪酸(n-3PUFA)具有多种健康益处,包括降低甘油三酯和降低心血管疾病风险。本综述重点介绍了正在开发的新处方ω-3 脂肪酸产品和最近发表的关于ω-3 脂肪酸对心律失常、心力衰竭和血小板失活影响的数据。
在低脂饮食的患者中,与处方ω-3-酸乙酯相比,n-3PUFA 的游离脂肪酸形式产生的血浆 n-3PUFA 曲线下面积高出四倍。二十碳五烯酸乙酯可降低甘油三酯,而不会显著升高严重高甘油三酯血症和混合性血脂异常患者的 LDL 胆固醇。最近对 n-3PUFA 对室性和房性心律失常的影响的研究,包括对植入除颤器的患者的研究,未能证明有显著益处。然而,增加食用富含 n-3PUFA 的鱼类或 n-3PUFA 的摄入与心力衰竭患者的住院率降低有关。另一个重要发现是当 n-3PUFA 与阿司匹林+氯吡格雷联合使用时,可增强抗血小板反应。
尽管 n-3PUFA 治疗在预防和治疗心血管疾病方面继续显示出希望,但仍需要进一步研究以更充分阐明其在特定疾病中的作用。