Gapinski J P, VanRuiswyk J V, Heudebert G R, Schectman G S
Department of Medicine, Medical College of Wisconsin, Milwaukee.
Arch Intern Med. 1993 Jul 12;153(13):1595-601.
No medical therapy has been shown to reduce the rate of restenosis following percutaneous transluminal coronary angioplasty. We examined the existing evidence for the use of omega-3 fatty acids in this capacity with the tool of meta-analysis.
A computerized search and a bibliographic review of published articles were performed. Abstracts were identified through journals, Index Medicus, and an unpublished listing of recent requests for fish oil for experimental use. All English-language randomized clinical trials with available reports were included in the analysis. The quality, design differences, and outcomes were evaluated for each study.
For four studies that used angiography to define coronary restenosis, the absolute difference in restenosis rates between treatment and control groups was 13.9% (95% confidence interval [CI], 3.2% to 24.5%). Furthermore, regression analysis revealed a positive linear relationship between the dose of omega-3 fatty acids used and the absolute difference in restenosis rates (r = .99, P < .03). When three studies that used stress testing as a means of determining restenosis rates were added to the four studies that used angiography, the risk difference was 5.1% (95% CI, -3.8% to 13.9%).
Restenosis after coronary angioplasty is reduced by supplemental fish oils, and the extent of the observed benefit may be dependent on the dose of omega-3 fatty acids used.
尚无医学疗法被证明可降低经皮腔内冠状动脉成形术后再狭窄的发生率。我们使用荟萃分析工具，研究了使用ω-3脂肪酸在此方面的现有证据。
进行了计算机检索和已发表文章的文献综述。通过期刊、《医学索引》以及一份未发表的近期实验用鱼油申请清单来识别摘要。所有有可用报告的英文随机临床试验均纳入分析。对每项研究的质量、设计差异和结果进行评估。
对于四项使用血管造影术定义冠状动脉再狭窄的研究，治疗组和对照组再狭窄率的绝对差异为13.9%（95%置信区间[CI]，3.2%至24.5%）。此外，回归分析显示所用ω-3脂肪酸剂量与再狭窄率的绝对差异之间存在正线性关系（r = 0.99，P < 0.03）。当将三项使用负荷试验作为确定再狭窄率手段的研究添加到四项使用血管造影术的研究中时，风险差异为5.1%（95%CI，-3.8%至13.9%）。
补充鱼油可降低冠状动脉成形术后的再狭窄，观察到的益处程度可能取决于所用ω-3脂肪酸的剂量。
