The underlying reasons for the highly inconsistent clinical outcome data for omega3polyunsaturated fatty acids (n3PUFAs) supplementation in patients with cardiac disease have not been understood yet. The aim of this prospective, randomized, doubleblind, placebo controlled study was to determine the effects of oral treatment with n3PUFAs on the antioxidant capacity of HDL in heart failure (HF) patients.
A total of 40 patients with advanced HF of nonischaemic origin, defined by NTproBNP levels of >2000 pg/mL, NYHA class III or IV and a LVEF <35% who were on stable optimized medical therapy for 3 months, were consecutively enrolled into this prospective, doubleblind, placebocontrolled trial and randomized in a 1:1:1 fashion to receive 1 g/day or 4 g/day of n3PUFA, or placebo, respectively, for 12 weeks.
After 12 weeks of treatment, the antioxidant function of HDL, measured by the HDL inflammatory index, was found significantly impaired in the treatment group in a dosedependent fashion with 0.67 [IQR 0.491.04] for placebo vs 0.71 [IQR 0.551.01] for 1 g/day n3PUFA vs 0.98 [IQR 0.731.16] for 4 g/day n3PUFA (P for trend = 0.018).
We provide evidence for an adverse effect of n3PUFA supplementation on antioxidant function of HDL in nonischaemic heart failure patients, establishing a potential mechanistic link for the controversial outcome data on n3PUFA supplementation.