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Eicosapentaenoic acid (EPA), a long-chain n-3 polyunsaturated fatty acid found in fish oil, is approved in Japan for treatment of hyperlipidemia and peripheral artery disease, and in Europe for reduction of mortality after myocardial infarction. But fish oil components have not been tested for primary prevention of heart disease in a high-risk population.
In this randomized study from Japan, 18,645 patients (mean age, 61) with total cholesterol levels of at least 251 mg/dL received a low-dose statin plus EPA (600 mg, 3 times daily) or a statin alone. Eighty percent of them had no history of cardiovascular disease, and none had had an acute cardiovascular event in the previous 6 months.
After an average 4.6 years of observation, significantly …