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. 2018 Oct;11(10):e005082.
doi: 10.1161/CIRCHEARTFAILURE.118.005082.

Omega-3 Therapy Is Associated With Reduced Gastrointestinal Bleeding in Patients With Continuous-Flow Left Ventricular Assist Device

Teruhiko Imamura  1 , Ann Nguyen  1 , Daniel Rodgers  1 , Gene Kim  1 , Jayant Raikhelkar  1 , Nitasha Sarswat  1 , Sara Kalantari  1 , Bryan Smith  1 , Ben Chung  1 , Nikhil Narang  1 , Colleen Juricek  2 , Daniel Burkhoff  3 , Tae Song  2 , Takeyoshi Ota  3 , Valluvan Jeevanandam  3 , Gabriel Sayer  1 , Nir Uriel  1
Affiliations

Omega-3 Therapy Is Associated With Reduced Gastrointestinal Bleeding in Patients With Continuous-Flow Left Ventricular Assist Device

Teruhiko Imamura et al. Circ Heart Fail. 2018 Oct.

Erratum in

Abstract

Background Gastrointestinal bleeding (GIB) is a common complication seen in patients supported with left ventricular assist devices (LVADs) and is related to increased inflammation and angiogenesis. Omega-3 is an unsaturated fatty acid that possesses anti-inflammatory and antiangiogenic properties. This study aims to assess the prophylactic efficacy of treatment with omega-3 on the incidence of GIB in LVAD patients. Methods and Results Among consecutive 166 LVAD patients enrolled in this analysis, 30 patients (49 years old and 26 male) received 4 mg/d of omega-3 therapy for 310±87 days and 136 patients in the control group (58 years old and 98 male) were observed for 302±102 days. One-year GIB-free rate was significantly higher in the omega-3 group as compared with the control group (97% versus 73%; P=0.02). Omega-3 therapy was associated with the occurrence of GIB in both the univariate (hazard ratio, 0.12; 95% CI, 0.02-0.91; P=0.040) and multivariate Cox proportional hazard ratio analyses (hazard ratio, 0.13; 95% CI, 0.02-0.98; P=0.047). The frequency of GIB was significantly lower in the omega-3 group (0.08±0.42 versus 0.37±0.93 events/y; P=0.01), accompanied by significantly lower blood product transfusion and shorter days in the hospital. The frequency of GIB remained lower among the omega-3 group after matching for patient background characteristics (96% versus 73%, P=0.028). Conclusions LVAD patients treated with omega-3 had a significant increase in freedom from GIB. A randomized controlled study is warranted to evaluate the use of omega-3 in LVAD patients.

Keywords: fish oil; freedom; incidence; inflammation; therapeutics.

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Conflict of interest statement

Disclosures

Dr Imamura receives financial funding from Fukuda Foundation for Medical Technology and Postdoctoral Fellowship for Research Abroad of Japan Society for the Promotion of Science. Dr Uriel receives consultant fee and grants support from Abbott and Medtronic; Dr Sayer receives consultant fees from Medtronic; Dr Jeevanandam receives consultant fee from Abbott. Dr Burkhoff receives consultant fee from Medtronic, Corvia Medical, Sensible Medical, Impulse Dynamics, Cardiac Implants, and educational grant support from Abiomed. The other authors report no conflicts.

Figures

Figure 1.
Figure 1.. Comparison of freedom from gastrointestinal (GI) bleeding (A) and GI bleeding rate (B) between the omega-3 group and control group.
*P<0.05 by log-rank test and †P<0.05 by Mann-Whitney U test.
Figure 2.
Figure 2.. Trends of hemoglobin level during the observational period in both groups.
*P<0.05 by unpaired t test between the groups. Vertical bars indicate SDs.
Figure 3.
Figure 3.. Comparison of freedom from gastrointestinal (GI) bleeding (A) and GI bleeding rate (B) between the omega-3 group and propensity-matched control group.
*P<0.05 by log-rank test and †P<0.05 by Mann-Whitney U test. Background was matched between 2 groups in age, sex, device types, and aspirin dose at discharge by using the propensity score matching analysis. Hazard ratio was calculated by Cox proportional hazard ratio analysis.
See this image and copyright information in PMC

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