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There are two possible reasons that STRENGTH provided negative results from omega 3 supplementation: (1) The DHA component of the combined (EPA/DHA) combination negated the benefits of EPA and/or (2) The levels of EPA achieved were insufficient and (sub par ) compared to prior trials eg JELIS and REDUCE-IT to achieve the CV benefits desired. The discussion regarding the corn oil placebo in STRENGTH and the mineral oil placebo in REDUCE-IT is an un-substantiated distractor. Further , the risks of atrial fibrillation are overblown and entirely dependent on the clinical risk substrate. The investigators in STRENGTH overcall the risks of omega 3 induced Atrial Fibrillation and overplay the failure of “all” omega 3’s. We await after JELIS and REDUCE-IT a third large trial to confirm what seems well established that pure EPA omega 3 in the right dose in addition to statin is a very powerful adjunct in the armamentarium for primary or secondary cardiovascular event prevention with NNT’s in the 15-25 range which is spectacular!
Do your patients report any unexpected benefits from taking Vascepa, maybe due to its anti-inflammatory nature? Obviously, the greatly reduced risk of heart attack/stroke/death is the primary benefit, just wondering about other positive effects it may have.
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