No effect of n-3 fatty acids on high-sensitivity C-reactive protein after myocardial infarction: The Alpha Omega Trial

Background Persistent inflammation plays a role in the pathogenesis of atherosclerosis. n-3 Fatty acids may have anti-inflammatory effects. This study examined the effect of plant-derived alpha-linolenic acid (ALA) and marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on high-sensitivity C-reactive protein (hsCRP), a systemic marker of (low-grade) inflammation. Design/Methods A supplementary study in the Alpha Omega Trial: a multicenter, double-blind, randomized, placebo-controlled trial of low-dose n-3 fatty acids. Patients were enrolled from 2002 to 2006 and followed for 40 months. A total of 2425 patients, aged 60–80 years (79% men), with a history of myocardial infarction, were randomly assigned to margarines supplemented with a targeted additional intake of 400¿mg/day EPA and DHA, 2¿g/day ALA, EPA-DHA plus ALA, or placebo for 40 months. Results Patients consumed on average 19.8¿g margarine/day, providing an additional amount of 238¿mg/day EPA with 158¿mg/day DHA, 1.98¿g/day ALA, or both, in the active treatment groups. In the placebo group, the geometric mean hsCRP (95% confidence interval (CI)) was 1.84¿mg/l (95% CI: +1.70 to +2.00) at baseline and 1.98¿mg/l (95% CI: 1.82 to 2.15) after 40 months (p¿