BREAKING NEWS : Allen County Councilman Joel Benz plans to accept TRAA executive director position Full Story

New study suggests fish oil derivative may benefit heart health

New numbers suggest that a purified fish oil derivative, a prescription drug called Vascepa, is more effective at preventing cardiovascular events than previ...

Posted: Mar 18, 2019 5:03 PM

New numbers suggest that a purified fish oil derivative, a prescription drug called Vascepa, is more effective at preventing cardiovascular events than previously thought.

The drug lowered the rate of these events in high-risk patients -- including strokes, heart attacks and deaths from cardiovascular causes -- by 30% overall versus placebo, according to a study published Monday in the Journal of the American College of Cardiology.

This is better than previously thought because because the study authors took into account not just first cardiovascular events as before, but also second, third, fourth events, and so on. Earlier results were announced by Irish drugmaker Amarin Pharma in September and then in a study released November in the New England Journal of Medicine.

"By looking only at first events, we underestimate the true underlying treatment benefit offered," study author Dr. Deepak L. Bhatt said in a statement Monday.

"With this drug, we are not only preventing that first heart attack but potentially the second stroke and maybe that third fatal event," said Bhatt, executive director of interventional cardiovascular programs at Brigham and Women's Hospital and professor of medicine at Harvard Medical School.

According to these latest data on cardiovascular episodes, Vascepa slashed first events by a quarter, second and third events by more than 30%, and later events by almost a half. The researchers estimated that by treating a thousand patients for five years, they could prevent 76 coronary revascularizations, 42 heart attacks, 14 strokes, 16 hospitalizations due to unstable angina and 12 deaths related to cardiovascular causes.

The study was funded by Amarin. The drug was previously approved by the US Food and Drug Administration in 2012 to lower triglycerides, a type of lipid, in excess of 500 mg/dL.

Vascepa is a prescription drug derived from a single omega-3 fatty acid isolated from fish. Patients received four grams per day, which Bhatt described as the rough equivalent of eating more than 20 servings of fish a week, according to the Monday statement. However, eating that much fish would also add saturated fats and other ingredients to one's diet, the statement followed.

Amarin gave early wind of the drug's positive results in a September note to investors, boosting company shares from $2.99 to more than $12. At the time, experts said the initial findings were not widely expected. The science behind fish oil and cardiovascular health has been inconclusive, and many studies have not shown a benefit.

"Fish oil studies have produced ambiguous results, but this component ... carries significant effect," said cardiologist Dr. Russell Luepker, a Mayo professor of public health at the University of Minnesota who was not involved in the trial. He said the latest results show "certainly more clear outcomes than just taking fish oil capsules."

In September, Luepker initially reserved judgment on the drug but now has a more positive view.

"The number of events prevented is not trivial," he said shortly after attending a presentation on the drug at a meeting of the American College of Cardiology on Monday. "It gives more meaning to something that many of us have suspected for years: that triglycerides are important, and treating people that have high triglycerides is a useful thing."

But cardiologist Dr. Rita Redberg raised additional concerns, saying in an email that a number of unanswered questions remain. For example, the most common events in the study were coronary revascularizations -- procedures like stents that bring blood flow back to the heart. However, she said this can be "quite subjective and done at the discretion of the investigator without objective criteria."

She also expressed concerns about how closely involved Amarin was "in all aspects of the study," which may cast "a large shadow of bias," said Redberg, a professor of medicine at the University of California, San Francisco who was also not involved in the trial.

"It is premature to recommend Vascepa," she said. "We should stick with our strong evidence-based recommendation to eat a Mediterranean style diet, including several servings of fish per week, to reduce cardiovascular risk."

Luepker also pointed out the prescription drug can cost in the ballpark of $300 per month, which is "not inexpensive," and said it was important to recognize who was represented in the study.

The 8,179 patients in the study had LDL levels in the normal range, controlled by statins, as well as elevated triglycerides. In addition, they either had "established cardiovascular disease," or they had Type 2 diabetes and at least one other cardiovascular risk factor. Patients were followed for a median 4.9 years.

The new study describes the drug as "well tolerated with no significant differences in rates of serious adverse events versus placebo." The researchers did find an increased risk of irregular heartbeat and bleeding, that was not linked to other serious events like stroke.

Additional questions remain about how the drug actually works. Experts say it's unclear whether the drug prevents cardiovascular events by acting directly on triglycerides or whether they are a marker for some other process going on in our bodies. Or perhaps some combination of the two.

Roughly a quarter of Americans age 20 and older have elevated triglycerides, according to data from the National Health and Nutrition Examination Survey. High triglycerides are associated with an increased risk of cardiovascular disease in combination with low HDL and high LDL, according to the US Centers for Disease Control and Prevention. The agency says lifestyle choices -- including exercise, weight loss, diet and quitting smoking -- can help lower triglycerides.

Heart disease is the top cause of death in the US, leading to the deaths of more than 600,000 per year.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 941120

Reported Deaths: 15315
CountyCasesDeaths
Marion1282511983
Lake633041097
Allen53609758
Hamilton43827447
St. Joseph41906590
Elkhart33545490
Vanderburgh30383448
Tippecanoe26820249
Johnson23609417
Hendricks22250341
Porter21737346
Clark17409229
Madison17366384
Vigo16108281
Monroe14466191
LaPorte14311239
Delaware14070221
Howard13865272
Kosciusko11418135
Hancock10841165
Warrick10674177
Bartholomew10542168
Floyd10430205
Wayne9959226
Grant9130204
Morgan8865160
Boone8389111
Dubois7710123
Dearborn762289
Henry7608130
Noble7413101
Marshall7362128
Cass7176117
Lawrence6957153
Shelby6584111
Jackson656785
Gibson6156107
Harrison603786
Huntington600195
Montgomery5805105
DeKalb574291
Knox5494104
Miami542488
Putnam536768
Clinton533665
Whitley524953
Steuben497268
Wabash483592
Jasper479160
Jefferson470092
Ripley454277
Adams444068
Daviess4169108
Scott405865
White391857
Clay390857
Greene388392
Decatur385296
Wells384983
Fayette374278
Posey359941
Jennings353156
Washington332047
LaGrange321375
Spencer317835
Fountain316555
Randolph312888
Sullivan307449
Owen283863
Starke280064
Fulton277553
Orange275859
Jay254837
Perry251652
Carroll243729
Franklin239338
Rush234130
Vermillion233250
Parke219820
Tipton209655
Pike207639
Blackford168334
Pulaski163551
Crawford146018
Newton144345
Benton142516
Brown135346
Martin128217
Switzerland125810
Warren114616
Union96911
Ohio79711
Unassigned0479

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1365800

Reported Deaths: 21596
CountyCasesDeaths
Franklin1522221560
Cuyahoga1344852327
Hamilton976051320
Montgomery670271141
Summit562091047
Lucas50900863
Butler47417655
Stark41580976
Lorain31567532
Warren30001331
Mahoning26963639
Clermont25628292
Lake24585417
Delaware22313145
Licking20487241
Fairfield20420221
Greene20309272
Trumbull19866509
Medina19796287
Clark17879328
Richland16314234
Portage16130229
Wood15681208
Allen14115256
Miami13786253
Muskingum12641152
Wayne11946238
Columbiana11708241
Tuscarawas10953269
Marion10725148
Pickaway10465129
Scioto10324127
Erie9747171
Ross9436176
Lawrence8755125
Hancock8458141
Ashtabula8317185
Geauga8173156
Belmont8140187
Jefferson7527172
Huron7423128
Union731851
Washington7183120
Athens697165
Sandusky6848134
Darke6756136
Knox6671122
Seneca6358137
Ashland5948113
Auglaize587188
Shelby5727101
Brown564171
Mercer557890
Defiance5483101
Madison543371
Crawford5425114
Highland541581
Fulton530683
Clinton525580
Logan512182
Preble4994110
Putnam4833106
Guernsey470364
Williams459282
Perry449852
Champaign445964
Ottawa436884
Jackson425362
Pike388843
Morrow383851
Fayette375853
Coshocton374766
Adams360675
Hardin359069
Gallia347356
Holmes3259108
Henry324668
Van Wert314670
Hocking301769
Wyandot280658
Carroll262652
Paulding242243
Meigs213942
Monroe189749
Noble169340
Morgan165829
Harrison157940
Vinton138118
Unassigned05
Fort Wayne
Partly Cloudy
48° wxIcon
Hi: 59° Lo: 47°
Feels Like: 46°
Angola
Partly Cloudy
52° wxIcon
Hi: 55° Lo: 46°
Feels Like: 52°
Huntington
Clear
48° wxIcon
Hi: 57° Lo: 47°
Feels Like: 46°
Decatur
Partly Cloudy
48° wxIcon
Hi: 57° Lo: 47°
Feels Like: 46°
Van Wert
Cloudy
53° wxIcon
Hi: 59° Lo: 47°
Feels Like: 53°
Sunshine and warmer air return to round out the work week, but the warm-up is brief.
WFFT Radar
WFFT Temperatures
WFFT National

Community Events