Zusammenfassung

BACKGROUND: Poor physical function impairs fitness and exercise and is associated with worse cardiovascular outcomes and all-cause mortality. Joint pain and stiffness limit physical function. OBJECTIVE: To determine if eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation improves physical function and exercise in coronary artery disease (CAD) patients. METHODS: 291 subjects with stable CAD were randomized to either Lovaza (1.86 g of EPA and 1.5 g of DHA daily) or no Lovaza (control) for 1 year. Change in pain, stiffness and physical function was assessed by the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Minutes of exercise per week were recorded, and musculoskeletal events were reported. RESULTS: Mean age (SD) was 63.3 (7.6) years. In the intention-to-treat analysis, compared to controls, those on Lovaza had better physical function (mean difference, −11.0%, 95% CI −18.5% to −3.5%, P = .004), better total WOMAC scores (mean difference, −9.8%, 95% CI −16.6% to −3.0%, P = .005), more exercise per week (135 minutes versus 197 minutes, respectively, P = .028) and less joint replacement (11 vs 1, respectively, P = .002). Pain and stiffness showed a trend toward significance (P = .06). The per-protocol analysis also showed less stiffness compared to controls (mean difference, −11.5%, 95% CI −22.9% to −0.1%, P = .048). CONCLUSION: High-dose EPA and DHA may benefit CAD patients by preserving physical function, increasing amount of exercise and reducing joint replacement. EPA and DHA may be a safe preventative strategy against musculoskeletal symptoms in CAD patients.