scholarly journals The Evolving Role of Omega 3 Fatty Acids in Cardiovascular Disease: Is Icosapent Ethyl the Answer?

2021 ◽  
Vol 15 (1) ◽  
pp. 7
Author(s):  
Suvasini Lakshmanan ◽  
Matthew J Budoff ◽  
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Author(s):  
GianLuca Colussi ◽  
Cristiana Catena ◽  
Elisa Nadalini ◽  
Alessandra Chiuch ◽  
Alessandro Di Fabio ◽  
...  

Author(s):  
Dhiren Patel ◽  
Robert Busch

Background: Atherosclerotic cardiovascular disease is a significant cause of morbidity and mortality worldwide. While use of statin therapy has improved management of lipids, an unmet need in reducing residual atherosclerotic cardiovascular disease risk and ischemic events persists. We provide an overview of the pharmacology of omega-3 fatty acids, omega-3 fatty acid cardiovascular outcomes trials, landmark clinical data and pharmacology of icosapent ethyl (a stable and highly purified ethyl ester of eicosapentaenoic acid), and the critical differences between fish oil supplements and prescription omega-3 fatty acids. Method: A PubMed literature review was conducted in April 2020 to identify articles discussing omega-3 fatty acid cardiovascular outcomes trials, pharmacology of icosapent ethyl, and the evaluation of fish oil dietary supplements and prescription omega-3 fatty acids. Results: Both eicosapentaenoic acid and docosahexaenoic acid have been widely associated with positive health benefits; however, data are inconsistent regarding the benefit of combination eicosapentaenoic acid and docosahexaenoic acid in patients with cardiovascular disease. Eicosapentaenoic acid, and specifically icosapent ethyl, has demonstrated atherosclerotic cardiovascular disease risk reduction among statin-treated patients. Important clinical differences exist between dietary supplement and prescription omega-3 fatty acid products. Conclusions: As research regarding the optimal management of dyslipidemia continues, additional therapy beyond statins is necessary to reduce atherosclerotic cardiovascular disease risk. In large cardiovascular outcomes trials, eicosapentaenoic acid has demonstrated cardiovascular benefit. Icosapent ethyl possesses a favorable efficacy and safety profile and should be considered as an adjunct to statin therapy to reduce ischemic event risk.


2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Zhi-Hong Yang ◽  
Boris Vaisman ◽  
Milton Pryor ◽  
Masahiro Bando ◽  
Daiju Fukuda ◽  
...  

Numerous studies have shown cardiovascular benefits of fish oil, and most of these favorable effects have been attributed to omega-3 fatty acids. Fish oils, however, also contain varying amounts of other unusual types of fatty acids, such as long-chain monounsaturated fatty acids (LCMUFA; i.e., C20:1 and C22:1 isomers combined). Compared with well-studied omega-3, limited information is available on the role of LCMUFA on cardiovascular disease. In the current study, we examined the effect of saury fish oil-derived LCMUFA concentrate on the pathogenesis of atherosclerosis in ApoE-deficient and LDLR-deficient mice. Male ApoE-deficient mice were fed a western diet supplemented with 5% LCMUFA concentrate or not (control) for 12 weeks. En face Sudan IV staining of the aorta revealed that LCMUFA significantly suppressed the development of atherosclerotic lesions, and down-regulated inflammatory gene expression. In LDLR-deficient female mice, we also observed that 12-week supplementation of 2% LCMUFA on a western diet significantly decreased atherosclerosis lesion areas and accumulation of macrophages, compared with western diet (control) or western diet supplemented with 2% olive oil enriched in shorter-chain MUFA oleic acid (C18:1). There were no differences, however, in plasma or hepatic lipid profiles between the three groups. LCMUFA, but not olive oil, also significantly suppressed several plasma inflammatory cytokine levels. RNA sequencing and subsequent qPCR analyses revealed that LCMUFA upregulated PPAR signaling pathways in liver. In cell culture studies, apoB-depleted plasma from the LCMUFA group promoted cholesterol efflux from macrophage-like THP-1 cells and ABCA1-overexpressing BHK cells. LCMUFA also suppressed LPS-induced inflammatory cytokine production by macrophages. In conclusion, our research showed for the first time that LCMUFA consumption could protects against atherosclerosis, possibly by upregulating the PPAR signaling pathway. Omega-3 fatty acids are generally considered the major active components in fish lipids, but our findings provide new insights into potential health effect of LCMUFA-rich fish oil and suggest that LCMUFA-rich fish oil may also be beneficial for reducing cardiovascular disease risk.


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