Supplementation with omega-3 acids after myocardial infarction and modification of inflammatory markers in light of the patients' diet: a preliminary study.

BACKGROUND: Neuroendocrine activation, activation of proinflammatory cytokines and platelets, and endothelial dysfunction play a significant role in the development of heart failure (HF). AIM: The aim of the work was to assess the effect of supplementation with EPA and DHA in a daily dose of 1 g on selected inflammatory markers and platelet activation in patients with HF after recent myocardial infarction in light of their diet. METHODS: This preliminary study was a randomised, double-blind trial involving 30 patients with post-infarction HF. One group received a product containing 1 g of omega-3 acids, while the other received placebo, i.e. corn oil 1 g daily for 12 weeks. At baseline and at week 12, venous blood was obtained in the fasted state in order to determine the following parameters: NT-proBNP, fibrinogen, INR, creatinine clearance, serum lipid profile, hsCRP, troponin, glucose, transaminases, GGTP, MCP-1, pentraxin 3, and CD-40. To evaluate the patient's diet and dietary intake of omega-3 acids, a 24-h dietary interview and the Block's Food Frequency Questionnaire (FFQ) were applied. RESULTS: Supplementation of omega-3 acids in a dose of 1 g per day had no effect on lipid or inflammatory parameters, with the exception of pentraxin 3. In both groups, after three months of supplementation, overall consumption of energy and saturated fatty acids was significantly higher (p < 0.05). CONCLUSIONS: Potential benefits associated with supplementation were nullified by a highly atherogenic diet. Apparently, supplementation of omega-3 acids without simultaneous dietary education and nutrition control does not bring the expected effect. Further research involving a larger group of patients is needed to better understand the relationship between patient's diet and the effectiveness of omega-3 supplementation.

[Diagnostic and prognostic significance of homocysteine determined in acute phase of myocardial infarction]. / Znaczenie rozpoznawczo-prognostyczne homocysteiny oznaczanej w ostrej fazie zawalu.

THE AIM: Of this study was to assess the serum homocysteine concentration in subjects with acute myocardial infarction and its correlation with the course of infarction and further prognosis considering particularly left ventricle dysfunction, heart rate and conduction disorders as well as to assess the usefulness of metionin load test as a prognostic test in patients with myocardial infarction. MATERIAL AND METHODS: 66 patients were studied: 36 with recent myocardial infarction and 30 healthy individuals as a control group. Fasting serum homocysteine and its concentration two hours after metionin load were determined in all patients. They all underwent echocardiographic examination, stress test and 24-hour Holter monitoring. The study revealed a significant positive correlation between increased serum homocysteine concentration in patients with myocardial infarction and worsening of contractility parameters, extent of infarction area, and negative correlation between homocysteine concentration and ejection fraction. CONCLUSIONS: On the basis of the study outcome we can make a statement that increased homocysteine concentration in patients with acute phase of myocardial infarction indicates its more severe course, more extensive disorders of myocardium kinetics, more significant left ventricle diastolic and systolic dysfunction. Increased serum homocysteine in metionin load test indicates higher death risk in patients with myocardial infarction.