Fish Oil and Mustard Oil as Treatment for Acute Myocardial Infarction
Fish Oil and Mustard Oil as Treatment for Acute Myocardial Infarction
August 1998; Volume 1: 95-96
Source: Singh RB, et al. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: The Indian experiment of infarct survival-4. Cardiovasc Drugs Ther 1997;11:485-491.
Researchers divided 360 patients with suspected acute myocardial infarction into three groups and gave one of three supplements approximately 18 hours after symptoms of infarction. A group of 122 patients received fish oil (eicosapentanoic acid [EPA], 1.08 g/d); 120 received mustard oil (alpha linolenic acid [ALA], 2.9 g/d); and 118 received a placebo. After one year, total cardiac deaths were significantly lower in the fish oil group vs. the placebo group (11.4% vs 22.0%; P < 0.05). Both fish and mustard groups had significantly fewer nonfatal myocardial infarctions than did the placebo group (13.0% and 15.0% vs 25.4%; P < 0.05), and also had fewer total cardiac arrhythmias, less left ventricular enlargement, and less angina pectoris. The study concluded that the rapid protective effects from supplementation in patients with acute myocardial infarction are apparent and suggested that they should be confirmed with a larger study.
COMMENT
Eating oily cold water fish rich in omega-3 fatty acids several times weekly (to yield 7 g omega-3s weekly) is likely to be protective against coronary disease and coronary artery thrombosis. There have been no previously reported studies that tested whether supplements protect against ischemic damage and complications.
The fish highest in these fatty acids are salmon, trout, and herring; these are also the fish with the highest total fat content per serving. Sardines, kippers (smoked herring), and mackerel are also right up there, on both accounts. ALA is a precursor to the omega-3 fatty acids, and EPA and docosahexnoic acid (DHA) are two of these fatty acids.
In a somewhat unconventional approach, these Indian researchers used only symptoms to assign admitted patients to the study. Thus, 292 actually had infarctions; 26 may have; 30 had unstable angina; 12 had noncardiac chest pain. Of note, patients also received usual care-which included hospitalization for 7-15 days and 1992-1994 drug therapy-and were advised to follow a low-fat, prudent diet.
Drop-outs were about the same across the groups; all patients except those who had died were re-assessed at one year. Nitrate, antiarrhythmic, and furosemide use were reported to be lower in the fish and mustard groups than placebo group. Two sudden deaths occurred in each of the fish and mustard groups; eight sudden deaths occurred in the placebo group. Total cardiac deaths were significantly lower in the fish group but not the mustard or placebo groups. Noncardiac deaths were not reported.
The authors speculate that a "decrease in free radical stress" may be responsible for their positive results. They note that EPA displaces arachidonic acid in the platelet prostaglandin pathway; less thromboxane A2 is produced; there is less platelet aggregation and thrombosis.
Do vegetarians have to trek to Mt. Horeb, WI, home of the Mustard Museum and 1400 kinds of mustard (at last count) to get these benefits? Nope. Flax seed and flax oil, purslane (a wild invasive green, the tops of which are tender), and walnuts are rich in ALA, too. However, whether that ALA has the same effects as the ALA in mustard oil remains to be seen.
These good-looking results are incomplete. A relatively small number of patients, significant differences in previous acute myocardial infarction and current smoking levels, and no information about fitness, stress reduction, or aerobic exercise make this a difficult study to mark as definitive.
Still, the study hints at therapy: Give people with symptoms of a heart attack something positive to do! They should eliminate saturated and trans fats, quit smoking, move atrophied muscles, and, perhaps, find the courage and support to change their lifestyle in an effort to reverse disease.
Conclusion
Omega-3 rich fish is delicious, and, if broiled, poached, grilled, or sauteed without additional oil (and with additional culinary herbs, spices, wet marinades, and dry rubs), it may also reduce complications in patients with suspected acute infarctions. Supplements should be considered in patients unable or unwilling to eat fish or look for omega-3s from vegetables, grains, and nuts. However, supplements should not be taken by those on coumadin or aspirin.
August 1998; Volume 1: 95-96Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.